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General NPI Number Information
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NPI Number | 1992614572
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Entity Type | Individual
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Provider Name | KARINA DERISI LSW
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Gender | Female
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Dates
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Enumeration Date | 09/01/2026
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Last Update Date | 09/02/2026
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Provider Practice Location Address
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Address Line | 28 VALLEY RD # 150
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City | MONTCLAIR
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State | NJ
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Zip | 07042-2709
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Country | US
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Telephone | 973-375-1509
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Fax |
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Provider Business Mailing Address
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Address Line | 136 E SPRINGTOWN RD
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City | LONG VALLEY
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State | NJ
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Zip | 07853-3341
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Country | US
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Telephone | 201-719-0450
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL07508600
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License Number State | NJ
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