Provider Demographics
NPI:1356128821
Name:HABER, LORI LYNN (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:LYNN
Last Name:HABER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 PORT MONMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:PORT MONMOUTH
Mailing Address - State:NJ
Mailing Address - Zip Code:07758-1676
Mailing Address - Country:US
Mailing Address - Phone:732-492-4739
Mailing Address - Fax:
Practice Address - Street 1:16 EMERSON ST STE 4
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-4400
Practice Address - Country:US
Practice Address - Phone:732-419-8103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC010282001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical