Provider Demographics
NPI:1376914309
Name:OSTROW, LIZA (MS, LPC)
Entity Type:Individual
Prefix:
First Name:LIZA
Middle Name:
Last Name:OSTROW
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 KINGS HWY N
Mailing Address - Street 2:206
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1909
Mailing Address - Country:US
Mailing Address - Phone:856-208-7300
Mailing Address - Fax:877-620-3085
Practice Address - Street 1:1050 KINGS HWY N
Practice Address - Street 2:206
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1909
Practice Address - Country:US
Practice Address - Phone:856-208-7300
Practice Address - Fax:877-620-3085
Is Sole Proprietor?:No
Enumeration Date:2015-10-16
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00500200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional