Provider Demographics
NPI:1811058043
Name:MONROY-ADVIS, EUGENIA A (LCSW)
Entity type:Individual
Prefix:MRS
First Name:EUGENIA
Middle Name:A
Last Name:MONROY-ADVIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 AMBOY AVE
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2455
Mailing Address - Country:US
Mailing Address - Phone:732-767-1424
Mailing Address - Fax:732-767-1490
Practice Address - Street 1:312 AMBOY AVE
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2455
Practice Address - Country:US
Practice Address - Phone:732-767-1424
Practice Address - Fax:732-767-1490
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC005752001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0018236Medicaid
NJ563975Medicare ID - Type Unspecified