Provider Demographics
NPI:1841975018
Name:ELACQUA, STAYLA (LCSW)
Entity type:Individual
Prefix:MS
First Name:STAYLA
Middle Name:
Last Name:ELACQUA
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 1:7 LAURELTON TRL
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-5503
Mailing Address - Country:US
Mailing Address - Phone:908-894-9393
Mailing Address - Fax:
Practice Address - Street 1:7 LAURELTON TRL
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-5503
Practice Address - Country:US
Practice Address - Phone:908-894-9393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-16
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC064243001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical