Provider Demographics
NPI:1053984757
Name:PAREDES, SERGIO
Entity type:Individual
Prefix:
First Name:SERGIO
Middle Name:
Last Name:PAREDES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 LOMBARDY ST UNIT 166
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-3210
Mailing Address - Country:US
Mailing Address - Phone:973-477-9641
Mailing Address - Fax:
Practice Address - Street 1:8 LOMBARDY ST UNIT 166
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-3210
Practice Address - Country:US
Practice Address - Phone:973-477-9641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor