Individual
MR. BENEDICT VICARISI JR JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.S
Contact information
Practice address
395 PLEASANT VALLEY WAY, WEST ORANGE, NJ 07052-2905
(973) 495-1818
(973) 495-1818
Mailing address
69 HAZEL AVENUE, WEST ORANGE, NJ 07052-4524
(973) 495-1818
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC01046
NJ
106H00000X
Marriage & Family Therapist
FI0014959
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232752
HEALTH NET MANAGED CARE
NJ
01
—
490655000
MAGELLAN BLUE CROSS
NJ
01
—
P2728931
OXFORD
NJ
Enumeration date
09/20/2006
Last updated
11/22/2024
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