Healthcare Provider Details

I. General information

NPI: 1437925880
Provider Name (Legal Business Name): DEIRDRE BERNAZ MSW, LCSW, LCADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2023
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 W MAIN ST # A-5
FREEHOLD NJ
07728-2140
US

IV. Provider business mailing address

1 GREEN ACRE DR
HAZLET NJ
07730-2324
US

V. Phone/Fax

Practice location:
  • Phone: 848-300-3933
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37LC00405900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06492000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: