Provider Demographics
NPI:1386047801
Name:ORBEGOSO, CERISSA ROSE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:CERISSA
Middle Name:ROSE
Last Name:ORBEGOSO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 CEDAR HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-1104
Mailing Address - Country:US
Mailing Address - Phone:203-667-6591
Mailing Address - Fax:
Practice Address - Street 1:381 HIGH RIDGE RD
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-3018
Practice Address - Country:US
Practice Address - Phone:203-977-5136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-29
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker