Provider Demographics
NPI:1952112898
Name:VARELA, LARISSA (LSW)
Entity type:Individual
Prefix:
First Name:LARISSA
Middle Name:
Last Name:VARELA
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 1:440 WHITON RD
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08853-4202
Mailing Address - Country:US
Mailing Address - Phone:908-239-2222
Mailing Address - Fax:
Practice Address - Street 1:50 DIVISION ST FL 3
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2943
Practice Address - Country:US
Practice Address - Phone:908-704-0011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL064093001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical