Provider Demographics
NPI:1689476483
Name:AKPAN, NKESEOBONG (LSW, LCADC)
Entity type:Individual
Prefix:
First Name:NKESEOBONG
Middle Name:
Last Name:AKPAN
Suffix:
Gender:
Credentials:LSW, LCADC
Other - Prefix:
Other - First Name:IRIS
Other - Middle Name:
Other - Last Name:AKPAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LSW, LCADC
Mailing Address - Street 1:2000 MORRIS PL UNIT 2312
Mailing Address - Street 2:
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936-0288
Mailing Address - Country:US
Mailing Address - Phone:862-777-1517
Mailing Address - Fax:
Practice Address - Street 1:2000 MORRIS PL UNIT 2312
Practice Address - Street 2:
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936-0288
Practice Address - Country:US
Practice Address - Phone:862-777-1517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06551100104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker