Provider Demographics
NPI:1104530765
Name:DENTON, ELYSSA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ELYSSA
Middle Name:
Last Name:DENTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 COLGATE WAY
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-5341
Mailing Address - Country:US
Mailing Address - Phone:973-220-8200
Mailing Address - Fax:
Practice Address - Street 1:1 BETHANY RD
Practice Address - Street 2:
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1663
Practice Address - Country:US
Practice Address - Phone:609-309-7574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053970001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical