Provider Demographics
NPI:1851461420
Name:MAYER, LORISE WIEN (LCSW, NCPSYA)
Entity Type:Individual
Prefix:MRS
First Name:LORISE
Middle Name:WIEN
Last Name:MAYER
Suffix:
Gender:F
Credentials:LCSW, NCPSYA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 VICTORIA LANE
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-2572
Mailing Address - Country:US
Mailing Address - Phone:201-906-6382
Mailing Address - Fax:
Practice Address - Street 1:14 VICTORIA LANE
Practice Address - Street 2:
Practice Address - City:MAHWAH
Practice Address - State:NJ
Practice Address - Zip Code:07430-2572
Practice Address - Country:US
Practice Address - Phone:201-906-6382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC048296001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical