MEDICARE: CASSANDRA LENZA LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	087038	NY

General Provider Information

NPI Number	:	1053712919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA LENZA LCSW

Provider Business Mailing Address
First Line	:	135 BLOOMFIELD ST APT 3
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-4695
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	112 W 27TH ST FL 7
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10001-6240
Country	:	US
Telephone Number	:	212-645-7903
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2014
Last Update Date	:	02/19/2019

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