Provider Demographics
NPI:1932608155
Name:GOSAIN, ANISHA SHAH (LCSW)
Entity type:Individual
Prefix:MS
First Name:ANISHA
Middle Name:SHAH
Last Name:GOSAIN
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 1:162 PENNSYLVANIA WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-3524
Mailing Address - Country:US
Mailing Address - Phone:201-962-6935
Mailing Address - Fax:
Practice Address - Street 1:362 SUNSET RD
Practice Address - Street 2:
Practice Address - City:SKILLMAN
Practice Address - State:NJ
Practice Address - Zip Code:08558-1641
Practice Address - Country:US
Practice Address - Phone:908-874-5153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-02
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057722001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical