Healthcare Provider Details

I. General information

NPI: 1184213654
Provider Name (Legal Business Name): ALYSSA CAHILL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2021
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 RIDGE TER
NEPTUNE CITY NJ
07753-6614
US

IV. Provider business mailing address

96 RIDGE TER
NEPTUNE CITY NJ
07753-6614
US

V. Phone/Fax

Practice location:
  • Phone: 732-449-5470
  • Fax:
Mailing address:
  • Phone: 732-449-5470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SC06379400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: