Provider Demographics
NPI:1518025329
Name:LAPA, NACHMAN (LCSW)
Entity type:Individual
Prefix:MR
First Name:NACHMAN
Middle Name:
Last Name:LAPA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 RIVER AVE
Mailing Address - Street 2:SUITE 120B
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4738
Mailing Address - Country:US
Mailing Address - Phone:732-552-7081
Mailing Address - Fax:732-370-2636
Practice Address - Street 1:500 RIVER AVE
Practice Address - Street 2:SUITE 120B
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4738
Practice Address - Country:US
Practice Address - Phone:732-552-7081
Practice Address - Fax:732-370-2636
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052934001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0029807Medicaid