Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | 44SL06172000 | NJ |
Y | 1041C0700X | Clinical Social Worker | 44SC05886600 | NJ |
NPI | 1003352212 |
---|---|
Provider Name | Ms. Ariana Luciano |
First Address | Jersey City, NJ 07304-2731 |
Second Address | Jersey City, NJ 07304-2731 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2017 |
Last Update Date | 03/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0023701 | (05) | NJ |