Individual
ASHLEY SAN GIACOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
42 MARLEY AVE, 1, CEDAR GROVE, NJ 07009-1139
(973) 903-1613
Mailing address
42 MARLEY AVE, 1, CEDAR GROVE, NJ 07009-1139
(973) 903-1613
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
44SLO5793600
NJ
1041C0700X
Clinical Social Worker
Primary
44SC05700600
NJ
1041S0200X
School Social Worker
856988
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0519120
—
NJ
Enumeration date
05/18/2016
Last updated
10/20/2016
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