Individual
MS. AGNES RAEVEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACSW, LCSW
Contact information
Practice address
3 THEATRE CTR, SPARTA, NJ 07871-2410
(973) 729-3722
(570) 296-2043
Mailing address
3 THEATRE CTR, SPARTA, NJ 07871-2410
(973) 729-3722
(570) 296-2043
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
SCO8663
NJ
103TA0400X
Addiction (Substance Use Disorder) Psychologist
SCO8663
NJ
103TA0700X
Adult Development & Aging Psychologist
SCO8663
NJ
103TC2200X
Clinical Child & Adolescent Psychologist
SCO8663
NJ
103TF0000X
Family Psychologist
SCO8663
NJ
103TP2701X
Group Psychotherapy Psychologist
SCO8663
NJ
103TR0400X
Rehabilitation Psychologist
SCO8663
NJ
104100000X
Social Worker
Primary
SCO8663
NJ
106H00000X
Marriage & Family Therapist
SCO8663
NJ
Other
Enumeration date
03/08/2007
Last updated
10/09/2013
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