Provider Demographics
NPI:1396174736
Name:SARIOL-CLOUGH, DEANNA M (MSW, LSW)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:M
Last Name:SARIOL-CLOUGH
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 RUCKMAN RD
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07642-1721
Mailing Address - Country:US
Mailing Address - Phone:551-427-1129
Mailing Address - Fax:
Practice Address - Street 1:254 RUCKMAN RD
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:NJ
Practice Address - Zip Code:07642-1721
Practice Address - Country:US
Practice Address - Phone:551-427-1129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL04790200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker