Jon Bercovici, LCSW

Individual provider Active NPI Clinical Social Worker · Hackensack, NJ

NPI 1831491497 · NPPES record last updated Dec 2, 2010

Key facts

NPI
1831491497
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
44SC00020000 (NJ)
Practice address
62 Summit Ave
Hackensack, NJ 07601-8562
Phone
(201) 546-7425
NPI assigned
Dec 2, 2010
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
44SC00020000NJMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC00020000 NJ Yes

Addresses

Primary practice location

62 Summit Ave
Hackensack, NJ 07601-8562

Mailing address

185 Prospect Ave
Apt 14 I
Hackensack, NJ 07601-2210
Phone (201) 446-6880

Other providers in Hackensack, NJ

All providers in Hackensack, NJ · Clinical Social Worker in New Jersey

Sources for this page

Verify at the official NPI Registry.