Individual provider · NPI-1

Jon Bercovici, LCSW

Social Worker, Clinical · Hackensack, NJ

NPI number1831491497
StatusActive
Last updated in NPPESDec 2, 2010

Details

NPI
1831491497
Entity type
Individual (NPI-1)
Name
Jon Bercovici
Credential
LCSW
Sex
Male
Sole proprietor
Yes
Enumeration date
Dec 2, 2010
Last updated
Dec 2, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical44SC00020000NJYes

Practice location

62 Summit Ave
Hackensack, NJ 07601-8562

Phone 201-546-7425

Mailing address

185 Prospect Ave
Apt 14 I
Hackensack, NJ 07601-2210

Phone 201-446-6880

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