Provider Demographics
NPI:1659501831
Name:HRESS, ILONA ANNE (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:ILONA
Middle Name:ANNE
Last Name:HRESS
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 1:95 MADISON AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940-1472
Mailing Address - Country:US
Mailing Address - Phone:972-822-5042
Mailing Address - Fax:973-822-0520
Practice Address - Street 1:95 MADISON AVE APT 1
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-1472
Practice Address - Country:US
Practice Address - Phone:972-822-5042
Practice Address - Fax:973-822-0520
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC046315001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical