Provider Demographics
NPI:1588711980
Name:BERRIO, DELFINA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DELFINA
Middle Name:
Last Name:BERRIO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 VALLEY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-2515
Mailing Address - Country:US
Mailing Address - Phone:908-247-6068
Mailing Address - Fax:201-610-9466
Practice Address - Street 1:615 PAVONIA AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-2923
Practice Address - Country:US
Practice Address - Phone:201-610-9466
Practice Address - Fax:201-610-0801
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC000855001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ662050L7NMedicare ID - Type UnspecifiedUPIN005474