Provider Demographics
NPI:1588993562
Name:ARIAS, ELLYSA (LCSW)
Entity type:Individual
Prefix:MISS
First Name:ELLYSA
Middle Name:
Last Name:ARIAS
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 1:4 VERMELLA WAY
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-2644
Mailing Address - Country:US
Mailing Address - Phone:631-464-3737
Mailing Address - Fax:
Practice Address - Street 1:4 VERMELLA WAY
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-2644
Practice Address - Country:US
Practice Address - Phone:631-464-3737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-21
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0898811041C0700X
NJ44SCO61323001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical