Basic Information
| Provider Information | |||||||||
| NPI: | 1336584440 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DESIMONE | ||||||||
| FirstName: | NATALIE | ||||||||
| MiddleName: | |||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1086 | ||||||||
| Address2: | |||||||||
| City: | PLEASANTVILLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082326086 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6092728580 | ||||||||
| FaxNumber: | 6096457343 | ||||||||
| Practice Location | |||||||||
| Address1: | 501 SCARBOROUGH DR | ||||||||
| Address2: | 3RD FLOOR, EAST WING | ||||||||
| City: | EGG HARBOR TOWNSHIP | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082344854 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6096465142 | ||||||||
| FaxNumber: | 6096467343 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2013 | ||||||||
| LastUpdateDate: | 05/02/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 44SC05538500 | NJ | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.