Provider Demographics
NPI:1376849075
Name:CRISAFI, LAURA PHYLLIS (LCSW)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:PHYLLIS
Last Name:CRISAFI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 7447
Mailing Address - Street 2:
Mailing Address - City:MONROE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831
Mailing Address - Country:US
Mailing Address - Phone:609-558-8212
Mailing Address - Fax:732-777-1889
Practice Address - Street 1:32 FORD AVENUE
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:MILLTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08850
Practice Address - Country:US
Practice Address - Phone:732-777-1940
Practice Address - Fax:732-777-1889
Is Sole Proprietor?:No
Enumeration Date:2011-01-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical