Provider Demographics
NPI:1699742973
Name:SENET, NANCIE M (PHD)
Entity type:Individual
Prefix:DR
First Name:NANCIE
Middle Name:M
Last Name:SENET
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:NANCIE
Other - Middle Name:VACCARO
Other - Last Name:SENET
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:560 MAIN ST
Mailing Address - Street 2:SUITE 1F
Mailing Address - City:ALLENHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07711-1231
Mailing Address - Country:US
Mailing Address - Phone:732-531-7792
Mailing Address - Fax:732-531-4044
Practice Address - Street 1:560 MAIN ST
Practice Address - Street 2:SUITE 1F
Practice Address - City:ALLENHURST
Practice Address - State:NJ
Practice Address - Zip Code:07711-1231
Practice Address - Country:US
Practice Address - Phone:732-531-7792
Practice Address - Fax:732-531-4044
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-04
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100392100103TC0700X, 103TP0814X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
051271Medicare ID - Type Unspecified