Provider Demographics
NPI:1982421228
Name:PHILLIPS, SADIA-ADU (LSW)
Entity type:Individual
Prefix:MS
First Name:SADIA-ADU
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 LINCOLN AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07660-1405
Mailing Address - Country:US
Mailing Address - Phone:201-877-3214
Mailing Address - Fax:
Practice Address - Street 1:201 LINCOLN AVE APT 2
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07660-1405
Practice Address - Country:US
Practice Address - Phone:201-877-3214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-25
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06910000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker