Provider Demographics
NPI:1558417600
Name:LYTWYN, NOELLE CELINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NOELLE
Middle Name:CELINE
Last Name:LYTWYN
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 1:8 IVY CT
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-2914
Mailing Address - Country:US
Mailing Address - Phone:732-566-4761
Mailing Address - Fax:
Practice Address - Street 1:661 SHREWSBURY AVE
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4134
Practice Address - Country:US
Practice Address - Phone:732-345-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker