Provider Demographics
NPI:1780252585
Name:CALEROPEREZ, ANGELICA MARIA (LSW)
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:MARIA
Last Name:CALEROPEREZ
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1092 BORDENTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:PARLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08859-1850
Mailing Address - Country:US
Mailing Address - Phone:386-216-5168
Mailing Address - Fax:
Practice Address - Street 1:126 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:ROSELLE
Practice Address - State:NJ
Practice Address - Zip Code:07203-1903
Practice Address - Country:US
Practice Address - Phone:386-216-5168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL066048001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty