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NPI Code Detail

MEDICARE: MS. LISA ANN CLOUSE MSW

MEDICARE: MS. LISA ANN CLOUSE MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1205040284
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LISA ANN CLOUSE MSW
Provider Business Mailing Address
First Line : 401 HANNIBAL ST
Second Line :
City : TOMS RIVER
State : NJ
Zip : 08757-3526
Country : US
Telephone Number : 732-244-9033
Fax Number :
Provider Business Practice Location Address
First Line : 166 MAIN ST
Second Line :
City : MATAWAN
State : NJ
Zip : 07747-3104
Country : US
Telephone Number : 732-566-7054
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2007
Last Update Date : 07/08/2007

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Directions to “ MS. LISA ANN CLOUSE MSW” Practice Location

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