Provider Demographics
NPI:1588789879
Name:MARESCA BEREZANSKY, CATHERINE M (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:M
Last Name:MARESCA BEREZANSKY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:BEREZANSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 22
Mailing Address - Street 2:
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-0022
Mailing Address - Country:US
Mailing Address - Phone:201-670-6814
Mailing Address - Fax:
Practice Address - Street 1:1172 E RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3936
Practice Address - Country:US
Practice Address - Phone:201-961-3270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053016001041C0700X
NY0753171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical