Provider Demographics
NPI:1295170975
Name:DEFRANCA, ELIEZER VIEIRA (LCSW, LCADC)
Entity type:Individual
Prefix:MR
First Name:ELIEZER
Middle Name:VIEIRA
Last Name:DEFRANCA
Suffix:
Gender:M
Credentials:LCSW, LCADC
Other - Prefix:MR
Other - First Name:ELIE
Other - Middle Name:
Other - Last Name:DE FRANCA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW, LCADC
Mailing Address - Street 1:127 WALCHEST DRIVE
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753
Mailing Address - Country:US
Mailing Address - Phone:862-485-0638
Mailing Address - Fax:
Practice Address - Street 1:127 WALCHEST DRIVE
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753
Practice Address - Country:US
Practice Address - Phone:862-485-0638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-07
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00153500101YA0400X
NJ44SC054366001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)