Provider Demographics
NPI:1518025246
Name:ELIZABETH ANN RASTELLI,LLC
Entity type:Organization
Organization Name:ELIZABETH ANN RASTELLI,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RASTELLI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-684-9855
Mailing Address - Street 1:1201 ROUTE 37 E
Mailing Address - Street 2:SUITE 8
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-5728
Mailing Address - Country:US
Mailing Address - Phone:732-684-9855
Mailing Address - Fax:732-270-8999
Practice Address - Street 1:1201 ROUTE 37 E
Practice Address - Street 2:SUITE 8
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-5728
Practice Address - Country:US
Practice Address - Phone:732-684-9855
Practice Address - Fax:732-270-8999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC043326001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty