Provider Demographics
NPI:1760716302
Name:STRAWBRIDGE, ELIZA (LCSW, MSED)
Entity Type:Individual
Prefix:MS
First Name:ELIZA
Middle Name:
Last Name:STRAWBRIDGE
Suffix:
Gender:F
Credentials:LCSW, MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 PARK AVENUE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07403
Mailing Address - Country:US
Mailing Address - Phone:631-258-6762
Mailing Address - Fax:
Practice Address - Street 1:3175 RT. 10 BUILDING C
Practice Address - Street 2:SUITE 700
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834
Practice Address - Country:US
Practice Address - Phone:862-200-7218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-30
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY082822104100000X
NY082773-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY082822OtherLICENSE