Provider Demographics
NPI:1841326881
Name:VERVERS, WARREN (MSW, LCSW, C-ASWCM)
Entity type:Individual
Prefix:MR
First Name:WARREN
Middle Name:
Last Name:VERVERS
Suffix:
Gender:M
Credentials:MSW, LCSW, C-ASWCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 ELDRIDGE ROAD
Mailing Address - Street 2:P. O. BOX 330
Mailing Address - City:MOUNT TABOR
Mailing Address - State:NJ
Mailing Address - Zip Code:07878
Mailing Address - Country:US
Mailing Address - Phone:973-349-8647
Mailing Address - Fax:
Practice Address - Street 1:12 ELDRIDGE ROAD
Practice Address - Street 2:
Practice Address - City:MOUNT TABOR
Practice Address - State:NJ
Practice Address - Zip Code:07878
Practice Address - Country:US
Practice Address - Phone:973-349-8647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC002216001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0023698Medicaid