Provider Demographics
NPI:1679744247
Name:HAYTAS, LORIANN ALEXANDRIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LORIANN
Middle Name:ALEXANDRIA
Last Name:HAYTAS
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 1:1 CRAVEN LN UNIT 6303
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-8014
Mailing Address - Country:US
Mailing Address - Phone:732-684-9707
Mailing Address - Fax:
Practice Address - Street 1:12 ROSZEL RD
Practice Address - Street 2:SUITE B204
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6234
Practice Address - Country:US
Practice Address - Phone:732-684-9707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-21
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052202001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical