Provider Demographics
NPI:1649329210
Name:PICARONI, LOUISE M (LCSW)
Entity type:Individual
Prefix:MS
First Name:LOUISE
Middle Name:M
Last Name:PICARONI
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 1:17 DANIELE DR
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-7910
Mailing Address - Country:US
Mailing Address - Phone:732-546-1291
Mailing Address - Fax:
Practice Address - Street 1:149 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2051
Practice Address - Country:US
Practice Address - Phone:732-780-9898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052343001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ222178319ZOtherHORIZON BCBS NJ