Provider Demographics
NPI:1962560680
Name:VACCARO, JANICE MARIE (LPC)
Entity type:Individual
Prefix:MS
First Name:JANICE
Middle Name:MARIE
Last Name:VACCARO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:DR
Other - First Name:JESSIE
Other - Middle Name:MARIE
Other - Last Name:VACCARO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:1044 PARKWAY AVE
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-2318
Mailing Address - Country:US
Mailing Address - Phone:609-883-6915
Mailing Address - Fax:
Practice Address - Street 1:50 N PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:PA
Practice Address - Zip Code:19067-1110
Practice Address - Country:US
Practice Address - Phone:215-428-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002308101YP1600X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
7856479OtherAETNA
11576042OtherCAQH