Ms Providencia Lebron, | |
275 Hobart St, Perth Amboy, NJ 08861-3396 | |
(908) 376-9333 | |
Not Available |
Full Name | Ms Providencia Lebron |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 275 Hobart St, Perth Amboy, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1396158523 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 44SL05948400 (New Jersey) | Primary |
Entity Name | Rutgers Health Behavioral Health |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1891956298 PECOS PAC ID: 2466346770 Enrollment ID: O20040419001021 |
Entity Name | Central Jersey Medical Center Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1932974250 PECOS PAC ID: 1456301241 Enrollment ID: O20050712000392 |
Mailing Address | Practice Location Address |
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Ms Providencia Lebron, Po Box 1220, Perth Amboy, NJ 08862-1220 Ph: (732) 376-9333 | Ms Providencia Lebron, 275 Hobart St, Perth Amboy, NJ 08861-3396 Ph: (908) 376-9333 |
Ms. Denise Rue, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 570 Lee Street, Raritan Bay Mental Health Center, Perth Amboy, NJ 08861 Phone: 732-442-1666 | |
Gerald Martin Rosenberg, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 570 Lee St, Perth Amboy, NJ 08861 Phone: 732-442-1666 Fax: 732-442-9512 | |
Alba J Vizcaino, LSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 570 Lee Street, Raritan Bay Mental Health Center, Perth Amboy, NJ 08861 Phone: 732-442-1666 | |
Jillian Leah Campion, LSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 220 Market St, Perth Amboy, NJ 08861 Phone: 732-709-7440 | |
Jacqueline Suzanne Stadler, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 570 Lee Street, Perth Amboy, NJ 08861 Phone: 732-442-1666 Fax: 732-442-9512 | |
Amanda E. Passman, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 570 Lee St, Perth Amboy, NJ 08861 Phone: 732-442-1666 | |
Miss Lorraine Frances Jacobs, MSW, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 570 Lee St, Perth Amboy, NJ 08861 Phone: 732-442-1666 |