Provider Demographics
NPI:1285795328
Name:SCHIRRIPA, ANJELICA (LSW)
Entity type:Individual
Prefix:
First Name:ANJELICA
Middle Name:
Last Name:SCHIRRIPA
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1157 ANTHONY CT
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-7404
Mailing Address - Country:US
Mailing Address - Phone:732-367-1710
Mailing Address - Fax:
Practice Address - Street 1:PREFERRED BEHAVIORAL HEALTH SAIL PROGRAM
Practice Address - Street 2:999 AIRPORT ROAD
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701
Practice Address - Country:US
Practice Address - Phone:732-367-1710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL054099001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical