Organization
ICCHOICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN PEGUERO LCSW (LICENSED CLINICAL SOCIAL WORKER)
(973) 647-4905
Entity
Organization
Contact information
Practice address
234 MAIN ST, LINCOLN PARK, NJ 07035-3704
(973) 647-4905
Mailing address
42 BARNEGAT RD, HEWITT, NJ 07421-3841
(973) 647-4905
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05426400
NJ
Other
Enumeration date
02/08/2011
Last updated
02/08/2011
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