Provider Demographics
NPI:1013487792
Name:JULIA C. DEL BALZO, LCSW, LLC
Entity type:Organization
Organization Name:JULIA C. DEL BALZO, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:TSAKALIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:201-540-8826
Mailing Address - Street 1:18 SYCAMORE AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:HO HO KUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07423-1500
Mailing Address - Country:US
Mailing Address - Phone:201-540-8826
Mailing Address - Fax:
Practice Address - Street 1:18 SYCAMORE AVE STE 2
Practice Address - Street 2:
Practice Address - City:HO HO KUS
Practice Address - State:NJ
Practice Address - Zip Code:07423-1500
Practice Address - Country:US
Practice Address - Phone:201-540-8826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-26
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1417346636Medicaid