Provider Demographics
NPI:1164005872
Name:GRASSO, LAUREN MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MARIE
Last Name:GRASSO
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 1:607 N JEROME AVE
Mailing Address - Street 2:
Mailing Address - City:MARGATE CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08402-1527
Mailing Address - Country:US
Mailing Address - Phone:609-822-1108
Mailing Address - Fax:609-822-1106
Practice Address - Street 1:607 N JEROME AVE
Practice Address - Street 2:
Practice Address - City:MARGATE CITY
Practice Address - State:NJ
Practice Address - Zip Code:08402-1527
Practice Address - Country:US
Practice Address - Phone:609-822-1108
Practice Address - Fax:609-822-1106
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC059462001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty