Provider Demographics
NPI:1740346238
Name:MASSEY-ALVARADO, RANDI (LCSW)
Entity type:Individual
Prefix:
First Name:RANDI
Middle Name:
Last Name:MASSEY-ALVARADO
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 1:1810 SHORE RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225-2220
Mailing Address - Country:US
Mailing Address - Phone:609-653-8600
Mailing Address - Fax:609-653-8612
Practice Address - Street 1:1810 SHORE RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-2220
Practice Address - Country:US
Practice Address - Phone:609-653-8600
Practice Address - Fax:609-653-8612
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC001988001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical