Healthcare Provider Details

I. General information

NPI: 1457009557
Provider Name (Legal Business Name): ELIZABETH WOODS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2022
Last Update Date: 03/17/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2038 CARMEL RD
MILLVILLE NJ
08332-9754
US

IV. Provider business mailing address

PO BOX 808
MILLVILLE NJ
08332-0808
US

V. Phone/Fax

Practice location:
  • Phone: 856-825-6810
  • Fax: 856-327-9020
Mailing address:
  • Phone: 856-825-6810
  • Fax: 856-327-9020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SC05932300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: