Provider Demographics
NPI:1194307819
Name:BERRIOS, JOSELYN A (MSW, LSW)
Entity type:Individual
Prefix:MS
First Name:JOSELYN
Middle Name:A
Last Name:BERRIOS
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 COLES ST APT 1
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-1929
Mailing Address - Country:US
Mailing Address - Phone:908-692-4347
Mailing Address - Fax:
Practice Address - Street 1:206 CLAREMONT AVE STE 2
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-3689
Practice Address - Country:US
Practice Address - Phone:732-902-2181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06279400104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker