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Organization
PAPA GANACHE PROJECT, LLC
Active
Organization
PAPA GANACHE PROJECT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA DALE SIROTI LCSW (PRINCIPAL)
(732) 770-0428
Entity
Organization
Contact information
Practice address
106 MAIN ST, MATAWAN, NJ 07747-2656
(732) 217-1750
(732) 217-1749
Mailing address
106 MAIN ST, MATAWAN, NJ 07747-2656
(732) 217-1750
(732) 217-1749
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
NJ
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0252069
—
NJ
Enumeration date
02/13/2014
Last updated
02/13/2014
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