Basic Information
| Provider Information | |||||||||
| NPI: | 1730592114 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DIGIOSE | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | |||||||||
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| Credential: | MA, LPC, LCADC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 JUMPING BROOK RD. | ||||||||
| Address2: | BLDG 5, STE 201, ATTN: BEHAVIORAL HEALTH CREDENTIALING | ||||||||
| City: | NEPTUNE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07753 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7326434363 | ||||||||
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| Practice Location | |||||||||
| Address1: | 661 SHREWSBURY AVE | ||||||||
| Address2: | |||||||||
| City: | SHREWSBURY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077024183 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7326434363 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2014 | ||||||||
| LastUpdateDate: | 02/04/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.