Provider Demographics
NPI:1053018614
Name:NICOTERA, ANTHONY (JD, DSW, LCSW)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:NICOTERA
Suffix:
Gender:M
Credentials:JD, DSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 UNDERCLIFF TER S
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-3811
Mailing Address - Country:US
Mailing Address - Phone:973-220-0084
Mailing Address - Fax:
Practice Address - Street 1:8 UNDERCLIFF TER S
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-3811
Practice Address - Country:US
Practice Address - Phone:973-220-0084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC061342001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical