Healthcare Provider Details

I. General information

NPI: 1821503053
Provider Name (Legal Business Name): PATRICIA ESPOSITO LCSW, CDVC, CCBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2017
Last Update Date: 02/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

534 CLIFTON AVE
CLIFTON NJ
07011-3230
US

IV. Provider business mailing address

534 CLIFTON AVE
CLIFTON NJ
07011-3230
US

V. Phone/Fax

Practice location:
  • Phone: 973-777-6490
  • Fax: 973-777-6491
Mailing address:
  • Phone: 973-777-6490
  • Fax: 973-777-6491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number074542-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05771700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: