Healthcare Provider Details

I. General information

NPI: 1003518390
Provider Name (Legal Business Name): SAMANTHA LYNN CIPARIS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 SYCAMORE AVE STE 2E
LITTLE SILVER NJ
07739-1248
US

IV. Provider business mailing address

32 SUNSET PL
NORTH MIDDLETOWN NJ
07748-5904
US

V. Phone/Fax

Practice location:
  • Phone: 732-947-4767
  • Fax:
Mailing address:
  • Phone: 908-601-0791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL06913700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: