Healthcare Provider Details

I. General information

NPI: 1477372811
Provider Name (Legal Business Name): SHANITA J ALVAREZ-CRAWLEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2024
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ENGLISH CREEK AVE BLDG 1000, STE 1000
EGG HARBOR TOWNSHIP NJ
08234
US

IV. Provider business mailing address

2500 ENGLISH CREEK AVE BLDG 1000, STE 1000
EGG HARBOR TOWNSHIP NJ
08234
US

V. Phone/Fax

Practice location:
  • Phone: 609-572-8394
  • Fax: 609-677-7210
Mailing address:
  • Phone: 609-572-8394
  • Fax: 609-677-7210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06391000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: