Healthcare Provider Details

I. General information

NPI: 1144928607
Provider Name (Legal Business Name): ELISE N. CLASSEN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2023
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date: 02/13/2026
Reactivation Date: 02/23/2026

III. Provider practice location address

117 BURLINGTON PATH RD
CREAM RIDGE NJ
08514-1604
US

IV. Provider business mailing address

117 BURLINGTON PATH RD
CREAM RIDGE NJ
08514-1604
US

V. Phone/Fax

Practice location:
  • Phone: 609-507-2783
  • Fax:
Mailing address:
  • Phone: 609-507-2783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06522000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: