Provider Demographics
NPI:1346308053
Name:COMERFORD, DONNA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:
Last Name:COMERFORD
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 1:1201 ROUTE 37 E
Mailing Address - Street 2:SUITE 8
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-5728
Mailing Address - Country:US
Mailing Address - Phone:732-270-2945
Mailing Address - Fax:732-367-8242
Practice Address - Street 1:1201 ROUTE 37 E
Practice Address - Street 2:SUITE 8
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-5728
Practice Address - Country:US
Practice Address - Phone:732-270-2945
Practice Address - Fax:732-367-8242
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053178001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0029807Medicaid