Provider Demographics
NPI:1992726558
Name:LASCARI, MARY BUSH (MSW)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:BUSH
Last Name:LASCARI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 N WASHINGTON AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DUNELLEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08812-1246
Mailing Address - Country:US
Mailing Address - Phone:732-563-4777
Mailing Address - Fax:732-563-4777
Practice Address - Street 1:216 N WASHINGTON AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:DUNELLEN
Practice Address - State:NJ
Practice Address - Zip Code:08812-1246
Practice Address - Country:US
Practice Address - Phone:732-563-4777
Practice Address - Fax:732-563-4777
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC004472001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ37FI00082300OtherLIC. MARRIAGE AND FAMILY
NJ44SC00447200OtherLIC. CLINICAL SOCIAL WORK