Individual
CHANA A. DERSHOWITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
545 E COUNTY LINE RD STE 17A, LAKEWOOD, NJ 08701-1487
(732) 330-6191
Mailing address
36 KEW GARDENS DR, LAKEWOOD, NJ 08701-7102
(732) 942-0886
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05775700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44SC05775700
LICENSED CLINICAL SOCIAL WORKER
NJ
Enumeration date
07/02/2018
Last updated
07/02/2018
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