Healthcare Provider Details

I. General information

NPI: 1407537277
Provider Name (Legal Business Name): LORENA BENAVIDES LAZO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2023
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

384 RIVER DR
GARFIELD NJ
07026-3327
US

IV. Provider business mailing address

384 RIVER DR
GARFIELD NJ
07026-3327
US

V. Phone/Fax

Practice location:
  • Phone: 201-424-2740
  • Fax:
Mailing address:
  • Phone: 201-424-2740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06179600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: