Individual
LISA STACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
61 GRAND AVE, ENGLEWOOD, NJ 07631-3572
(201) 568-0239
(201) 568-9780
Mailing address
61 GRAND AVE, ENGLEWOOD, NJ 07631-3572
(201) 568-0239
(201) 568-9780
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
071928-1
NY
1041C0700X
Clinical Social Worker
44SC05182900
NJ
Other
Enumeration date
10/14/2009
Last updated
04/06/2017
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