Provider Demographics
NPI:1740687383
Name:CARD, ELISABETH (LCSW)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:
Last Name:CARD
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 1:2164 HIGHWAY 35
Mailing Address - Street 2:BUILDING C, SUITE 12
Mailing Address - City:SEA GIRT
Mailing Address - State:NJ
Mailing Address - Zip Code:08750-1013
Mailing Address - Country:US
Mailing Address - Phone:848-223-1875
Mailing Address - Fax:
Practice Address - Street 1:2164 HIGHWAY 35
Practice Address - Street 2:BUILDING C, SUITE 12
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750-1013
Practice Address - Country:US
Practice Address - Phone:848-223-1875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-25
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC056126001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical