Individual
MS. BENEDETTA VERSACI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
65 RAMAPO VALLEY RD STE 102, MAHWAH, NJ 07430-1182
(973) 530-4155
(973) 273-4797
Mailing address
65 RAMAPO VALLEY RD STE 102, MAHWAH, NJ 07430-1182
(973) 530-4155
(973) 273-4797
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05397900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0231631
—
NJ
01
—
187739
MEDICARE PTAN
NJ
01
—
244195
MEDICARE PTAN
NJ
01
—
44SC05397900
NJ BOARD OF SOCIAL WORKERS LICENSE NO.
NJ
Enumeration date
07/01/2009
Last updated
07/06/2019
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