Provider Demographics
NPI:1346541083
Name:DELBALZO, MARY BETH (CHT, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARY BETH
Middle Name:
Last Name:DELBALZO
Suffix:
Gender:F
Credentials:CHT, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 SYCAMORE AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HO HO KUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07423-1582
Mailing Address - Country:US
Mailing Address - Phone:201-394-2319
Mailing Address - Fax:207-327-3299
Practice Address - Street 1:18 SYCAMORE AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:HO HO KUS
Practice Address - State:NJ
Practice Address - Zip Code:07423-1582
Practice Address - Country:US
Practice Address - Phone:201-394-2319
Practice Address - Fax:207-327-3299
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-11
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ445C05359001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical