Provider Demographics
NPI:1922453588
Name:SCRIVO, STEVEN JR (LPC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:SCRIVO
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 163
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009-0163
Mailing Address - Country:US
Mailing Address - Phone:973-941-7312
Mailing Address - Fax:
Practice Address - Street 1:145 RIDGE RD APT B
Practice Address - Street 2:
Practice Address - City:CEDAR GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07009-2070
Practice Address - Country:US
Practice Address - Phone:973-941-7312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2021-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00619900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0419095Medicaid
NJ0356935Medicaid