Healthcare Provider Details

I. General information

NPI: 1598530719
Provider Name (Legal Business Name): JULIE DALEY, LCSW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2023
Last Update Date: 11/17/2023
Certification Date: 11/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 W FRONT ST STE 11
RED BANK NJ
07701-1600
US

IV. Provider business mailing address

101 BLACK POINT RD
RUMSON NJ
07760-1709
US

V. Phone/Fax

Practice location:
  • Phone: 732-682-0030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: JULIE ANNE DALEY
Title or Position: PSYCHOTHERAPIST
Credential:
Phone: 732-682-0030