Healthcare Provider Details

I. General information

NPI: 1821423146
Provider Name (Legal Business Name): DANIELLE PLIVER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2013
Last Update Date: 05/31/2022
Certification Date: 05/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 CROSS ST STE 232
LAKEWOOD NJ
08701-4029
US

IV. Provider business mailing address

701 CROSS STREET SUITE 232
LAKEWOOD NJ
08701
US

V. Phone/Fax

Practice location:
  • Phone: 732-504-9819
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05882700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: