Provider Demographics
NPI:1871517722
Name:PARENTE, SUSAN C (PSYD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:C
Last Name:PARENTE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 GLENRIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-5008
Mailing Address - Country:US
Mailing Address - Phone:973-744-9845
Mailing Address - Fax:
Practice Address - Street 1:303 CLAREMONT AVE
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2813
Practice Address - Country:US
Practice Address - Phone:973-509-1113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100323900103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist