Provider Demographics
NPI:1962092916
Name:LORI M SPARZO LCSW
Entity type:Organization
Organization Name:LORI M SPARZO LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:M
Authorized Official - Last Name:SPARZO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:609-240-7020
Mailing Address - Street 1:406 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-2659
Mailing Address - Country:US
Mailing Address - Phone:609-240-7020
Mailing Address - Fax:
Practice Address - Street 1:406 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08618-2659
Practice Address - Country:US
Practice Address - Phone:609-240-7020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-24
Last Update Date:2021-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty