Provider Demographics
NPI:1013297936
Name:STOREY, LOU (LCSW, LCADC)
Entity Type:Individual
Prefix:
First Name:LOU
Middle Name:
Last Name:STOREY
Suffix:
Gender:M
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 W FRONT ST
Mailing Address - Street 2:SUITE 14A
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1624
Mailing Address - Country:US
Mailing Address - Phone:732-530-0742
Mailing Address - Fax:732-530-0742
Practice Address - Street 1:43 W FRONT ST
Practice Address - Street 2:SUITE 14A
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1624
Practice Address - Country:US
Practice Address - Phone:732-530-0742
Practice Address - Fax:732-530-0742
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00175100101YA0400X
NJ44SC054312001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)