Provider Demographics
NPI:1962262683
Name:ZAKS, ANGELIQUE JULIET (MSW, LSW)
Entity type:Individual
Prefix:MS
First Name:ANGELIQUE
Middle Name:JULIET
Last Name:ZAKS
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 OAK TREE DR APT L
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1796
Mailing Address - Country:US
Mailing Address - Phone:732-682-6214
Mailing Address - Fax:
Practice Address - Street 1:1450 OAK TREE DR APT L
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-1796
Practice Address - Country:US
Practice Address - Phone:732-682-6214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL069504001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical