Individual provider · NPI-1

Tara A. Augustine, LCSW

Social Worker, Clinical · Fair Lawn, NJ

NPI number1306139969
StatusActive
Last updated in NPPESMay 16, 2011

Details

NPI
1306139969
Entity type
Individual (NPI-1)
Name
Tara A. Augustine
Credential
LCSW
Sex
Female
Sole proprietor
No
Enumeration date
May 16, 2011
Last updated
May 16, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical44sc04789900NJYes

Practice location

17-07 Romaine St
Fair Lawn, NJ 07410-2150

Phone 201-797-2660

Mailing address

17-07 Romaine St
Fair Lawn, NJ 07410-2150

Phone 201-797-2660

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