Provider Demographics
NPI:1083373823
Name:MORREALE-LAFOCA, ANN MARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANN MARIE
Middle Name:
Last Name:MORREALE-LAFOCA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 FARMHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN TOP
Mailing Address - State:PA
Mailing Address - Zip Code:18707-1720
Mailing Address - Country:US
Mailing Address - Phone:570-954-9938
Mailing Address - Fax:
Practice Address - Street 1:63 FARMHOUSE RD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN TOP
Practice Address - State:PA
Practice Address - Zip Code:18707-1720
Practice Address - Country:US
Practice Address - Phone:570-954-9938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0223391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical