Provider Demographics
NPI:1891931317
Name:ANNETTE VICARI APPLEHEIMER, PSY.D.,L.L.C.
Entity type:Organization
Organization Name:ANNETTE VICARI APPLEHEIMER, PSY.D.,L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:VICARI APPLEHEIMER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:732-701-9860
Mailing Address - Street 1:1101 RICHMOND AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:POINT PLEASANT BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-3010
Mailing Address - Country:US
Mailing Address - Phone:732-701-9860
Mailing Address - Fax:
Practice Address - Street 1:1101 RICHMOND AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:POINT PLEASANT BEACH
Practice Address - State:NJ
Practice Address - Zip Code:08742-3010
Practice Address - Country:US
Practice Address - Phone:732-701-9860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100311300103TC2200X, 103TA0700X, 103TC0700X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ444278Medicaid
NJ3113OtherPSYCHOLOGIST LICENSE