Healthcare Provider Details

I. General information

NPI: 1578477071
Provider Name (Legal Business Name): MICHAEL MILIZZO LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 DAVIDSON AVE STE 306
SOMERSET NJ
08873-4144
US

IV. Provider business mailing address

220 DAVIDSON AVE STE 306
SOMERSET NJ
08873-4144
US

V. Phone/Fax

Practice location:
  • Phone: 732-997-0707
  • Fax: 732-997-0709
Mailing address:
  • Phone: 732-997-0707
  • Fax: 732-997-0709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06584400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: