Provider Demographics
NPI:1326334749
Name:LAMPERT, STACEY ALYSE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:ALYSE
Last Name:LAMPERT
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 1:52 PERRINEVILLE RD.
Mailing Address - Street 2:
Mailing Address - City:MONROE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831
Mailing Address - Country:US
Mailing Address - Phone:609-395-7979
Mailing Address - Fax:609-395-7129
Practice Address - Street 1:52 PERRINEVILLE RD.
Practice Address - Street 2:
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831
Practice Address - Country:US
Practice Address - Phone:609-395-7979
Practice Address - Fax:609-395-7129
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054643001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical