Provider Demographics
NPI:1427675693
Name:ABU-BAKR, VIRGINIA (MSW, LCSW,RPT)
Entity type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:
Last Name:ABU-BAKR
Suffix:
Gender:F
Credentials:MSW, LCSW,RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 LAHIERE AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-3127
Mailing Address - Country:US
Mailing Address - Phone:201-988-2619
Mailing Address - Fax:
Practice Address - Street 1:4 LAHIERE AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-3127
Practice Address - Country:US
Practice Address - Phone:201-988-2619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC014863001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical