Healthcare Provider Details

I. General information

NPI: 1134066723
Provider Name (Legal Business Name): ERICA BLUESTONE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 S 5TH ST APT 2157
HARRISON NJ
07029-2045
US

IV. Provider business mailing address

1200 S 5TH ST APT 2157
HARRISON NJ
07029-2045
US

V. Phone/Fax

Practice location:
  • Phone: 973-417-3071
  • Fax:
Mailing address:
  • Phone: 973-417-3071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06643200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: