Healthcare Provider Details

I. General information

NPI: 1699459941
Provider Name (Legal Business Name): JOSELIN HERRERA, LCSW P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1078 SUMMIT AVE # 700
JERSEY CITY NJ
07307-3438
US

IV. Provider business mailing address

1078 SUMMIT AVE # 700
JERSEY CITY NJ
07307-3438
US

V. Phone/Fax

Practice location:
  • Phone: 917-410-8189
  • Fax:
Mailing address:
  • Phone: 917-410-8189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOSELIN HERRERA
Title or Position: PRESIDENT
Credential: LCSW
Phone: 917-410-8189