Provider Demographics
NPI:1114669306
Name:DELORENZO, ASHLEY (LCSW, RPT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:DELORENZO
Suffix:
Gender:F
Credentials:LCSW, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 ALEXIS DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07727-3648
Mailing Address - Country:US
Mailing Address - Phone:908-727-2277
Mailing Address - Fax:
Practice Address - Street 1:55 ROUTE 35 STE 6
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5918
Practice Address - Country:US
Practice Address - Phone:732-784-7793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-08
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC056035001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical