Provider Demographics
NPI:1235821562
Name:HERNANDEZ, ANA EDDIK (MSW, LSW)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:EDDIK
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 GIBSON BLVD APT 5
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-1445
Mailing Address - Country:US
Mailing Address - Phone:732-540-7284
Mailing Address - Fax:
Practice Address - Street 1:777 ROUTE 70 E STE G101
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2548
Practice Address - Country:US
Practice Address - Phone:800-413-8020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-24
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC064625001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical