Provider Demographics
NPI:1558713461
Name:ZAFFARESE, LISA (LPC)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:ZAFFARESE
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 1:1200 JUMPING BROOK RD
Mailing Address - Street 2:BLDG 5, STE 201, ATTN: BEHAVIORAL HEALTH CREDENTIALING
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-2634
Mailing Address - Country:US
Mailing Address - Phone:732-643-4372
Mailing Address - Fax:732-643-4376
Practice Address - Street 1:402 ROUTE 35 N
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4604
Practice Address - Country:US
Practice Address - Phone:732-643-4363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00546300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional