Provider Demographics
NPI:1336645415
Name:DELORENZO, ALISHA (LPC)
Entity Type:Individual
Prefix:MS
First Name:ALISHA
Middle Name:
Last Name:DELORENZO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 501
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-0501
Mailing Address - Country:US
Mailing Address - Phone:973-626-4114
Mailing Address - Fax:
Practice Address - Street 1:85 DAVIS LN
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5507
Practice Address - Country:US
Practice Address - Phone:973-626-4114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00625900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional