Provider Demographics
NPI:1710210299
Name:MAHFOUD, ELIZABETH (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:MAHFOUD
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 PIERSON AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-3118
Mailing Address - Country:US
Mailing Address - Phone:732-494-8558
Mailing Address - Fax:732-494-8969
Practice Address - Street 1:295 PIERSON AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-3118
Practice Address - Country:US
Practice Address - Phone:732-494-8558
Practice Address - Fax:732-494-8969
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC051948001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical