Provider Demographics
NPI:1194851378
Name:AGRESTA, DARLENE ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:ANN
Last Name:AGRESTA
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 1:10 COOPER CT
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-4310
Mailing Address - Country:US
Mailing Address - Phone:732-308-9499
Mailing Address - Fax:732-866-3921
Practice Address - Street 1:167 MAIN ST
Practice Address - Street 2:SUITE 2B
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2744
Practice Address - Country:US
Practice Address - Phone:732-519-8871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC005247001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical