Provider Demographics
NPI:1699805424
Name:PROSPERI, PENELOPE B (MSW)
Entity type:Individual
Prefix:MRS
First Name:PENELOPE
Middle Name:B
Last Name:PROSPERI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MORGAN RD
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-3322
Mailing Address - Country:US
Mailing Address - Phone:973-228-3000
Mailing Address - Fax:973-228-2742
Practice Address - Street 1:14 PARK AVE
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-4902
Practice Address - Country:US
Practice Address - Phone:973-228-3000
Practice Address - Fax:973-228-2742
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC014635001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical