MEDICARE: ALYSSA SPITZ LCSW

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
1	104100000X	Social Worker	080576	NY
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1376770123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA SPITZ LCSW

Provider Business Mailing Address
First Line	:	PO BOX 3016
Second Line	:
City	:	SOUTH HACKENSACK
State	:	NJ
Zip	:	07606-1016
Country	:	US
Telephone Number	:	201-488-6678
Fax Number	:	201-342-4346

Provider Business Practice Location Address
First Line	:	70 HILLTOP RD STE 3025
Second Line	:
City	:	RAMSEY
State	:	NJ
Zip	:	07446-1155
Country	:	US
Telephone Number	:	201-488-6678
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2009
Last Update Date	:	03/30/2022

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Directions to “ ALYSSA SPITZ LCSW” Practice Location

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