Provider Demographics
NPI:1568906782
Name:ALLOTTA, LAWRENCE (LCSW)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:ALLOTTA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 CHESTNUT ST
Mailing Address - Street 2:SUITE 201 EAST #4
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630-1174
Mailing Address - Country:US
Mailing Address - Phone:201-477-0547
Mailing Address - Fax:
Practice Address - Street 1:16 CHESTNUT ST
Practice Address - Street 2:SUITE 201 EAST #4
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1174
Practice Address - Country:US
Practice Address - Phone:201-477-0547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055046001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical