Provider Demographics
NPI:1679780878
Name:ASTOR-LAZARUS, DONNA S (LCSW)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:S
Last Name:ASTOR-LAZARUS
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 1:98 TAMARACK CIR
Mailing Address - Street 2:
Mailing Address - City:SKILLMAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08558-2020
Mailing Address - Country:US
Mailing Address - Phone:609-683-9122
Mailing Address - Fax:609-683-5229
Practice Address - Street 1:98 TAMARACK CIR
Practice Address - Street 2:
Practice Address - City:SKILLMAN
Practice Address - State:NJ
Practice Address - Zip Code:08558-2020
Practice Address - Country:US
Practice Address - Phone:609-683-9122
Practice Address - Fax:609-683-5229
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC010223001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical