Provider Demographics
NPI:1437657657
Name:RALPH BIANCA, PH.D., L.C.S.W., L.C.A.D.C, LLC
Entity type:Organization
Organization Name:RALPH BIANCA, PH.D., L.C.S.W., L.C.A.D.C, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:BIANCA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW, LCADC
Authorized Official - Phone:908-312-2019
Mailing Address - Street 1:800 OLD SPRINGFIELD AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-1129
Mailing Address - Country:US
Mailing Address - Phone:908-312-2019
Mailing Address - Fax:
Practice Address - Street 1:800 OLD SPRINGFIELD AVE APT 7
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-1129
Practice Address - Country:US
Practice Address - Phone:908-312-2019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-23
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05738400261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center