Bevacqua, Richard

Bevacqua, Richard is an sole proprietor health care provider with primary practice located at Preferred Behavioral Health Sail Program 999 Airport Road, Lakewood NJ 08701. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Bevacqua, Richard can be contacted via phone (732) 367-1710.

Contact Information

Primary practice address
Preferred Behavioral Health Sail Program 999 Airport Road Lakewood NJ 08701
Phone: (732) 367-1710
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 44SC00836300 New Jersey

Profile Details

NPI number 1558409532
LBN Legal business name Bevacqua, Richard
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 2nd, 2007
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558409532 NPPES
New Jersey MEDICAID 8382603

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