Provider Demographics
NPI:1962888040
Name:VANI, PALAK (LSW)
Entity type:Individual
Prefix:
First Name:PALAK
Middle Name:
Last Name:VANI
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 HUDSON ST APT 1008
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-5695
Mailing Address - Country:US
Mailing Address - Phone:248-379-0093
Mailing Address - Fax:
Practice Address - Street 1:30 VENUS DR
Practice Address - Street 2:
Practice Address - City:CLOSTER
Practice Address - State:NJ
Practice Address - Zip Code:07624-2316
Practice Address - Country:US
Practice Address - Phone:917-692-8679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL07053500104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker