Healthcare Provider Details

I. General information

NPI: 1003202987
Provider Name (Legal Business Name): IRMA SANDOVAL-AROCHO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2015
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 WILSON AVE
TRENTON NJ
08620-9627
US

IV. Provider business mailing address

19 WILSON AVE
TRENTON NJ
08620-9627
US

V. Phone/Fax

Practice location:
  • Phone: 609-647-2597
  • Fax:
Mailing address:
  • Phone: 609-647-2597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number542498
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number13672
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05583400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: