MEDICARE: JENICE ACOSTA LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	44SC06213200	NJ
2	1041C0700X	Clinical Social Worker	094609	NY

General Provider Information

NPI Number	:	1245794007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENICE ACOSTA LCSW

Provider Business Mailing Address
First Line	:	220 9TH ST STE 2060
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-4288
Country	:	US
Telephone Number	:	917-524-9372
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 9TH ST STE 2060
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-4288
Country	:	US
Telephone Number	:	917-524-9372
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2019
Last Update Date	:	01/05/2026

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Directions to “ JENICE ACOSTA LCSW” Practice Location

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