Provider Demographics
NPI:1417848656
Name:ONOFRI, PHILLIP J (LAC)
Entity type:Individual
Prefix:
First Name:PHILLIP
Middle Name:J
Last Name:ONOFRI
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 NOMAHEGAN CT
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-1513
Mailing Address - Country:US
Mailing Address - Phone:908-425-6386
Mailing Address - Fax:
Practice Address - Street 1:21 NOMAHEGAN CT
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-1513
Practice Address - Country:US
Practice Address - Phone:908-425-6386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00887900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health