Provider Demographics
NPI:1023685534
Name:OSBORN, LISA DIANE (MA, MSW, LSW)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:DIANE
Last Name:OSBORN
Suffix:
Gender:F
Credentials:MA, MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:JOURNEYS OUTPATIENT SERVICES
Mailing Address - Street 2:313 WEST WATER ST.
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753
Mailing Address - Country:US
Mailing Address - Phone:732-333-6840
Mailing Address - Fax:
Practice Address - Street 1:JOURNEYS OUTPATIENT SERVICES
Practice Address - Street 2:313 WEST WATER ST.
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753
Practice Address - Country:US
Practice Address - Phone:732-333-6840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL066337001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical