Healthcare Provider Details

I. General information

NPI: 1417506924
Provider Name (Legal Business Name): ENGLIDE CAJUSTE CLINICAL SOCIAL WORK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2019
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 EAST AVE
AUSTIN TX
78701-4323
US

IV. Provider business mailing address

525 ROUTE 73 N STE 104
MARLTON NJ
08053-3422
US

V. Phone/Fax

Practice location:
  • Phone: 908-468-9325
  • Fax:
Mailing address:
  • Phone: 908-468-9325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW24941
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC24863
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05876200
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number103859
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: