Provider Demographics
NPI:1184995771
Name:PITKOWSKY, LORI (MSW, NBC-HWC)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:PITKOWSKY
Suffix:
Gender:F
Credentials:MSW, NBC-HWC
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:PITKOWSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, NBC-HWC
Mailing Address - Street 1:PO BOX 786
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-0786
Mailing Address - Country:US
Mailing Address - Phone:973-953-6098
Mailing Address - Fax:
Practice Address - Street 1:374 MILLBURN AVE
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1358
Practice Address - Country:US
Practice Address - Phone:973-953-6098
Practice Address - Fax:973-379-5511
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-13
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL043114001041C0700X
NJ3267378
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical