Provider Demographics
NPI:1043587496
Name:ENCARNACION, SAUDI (LSW)
Entity Type:Individual
Prefix:
First Name:SAUDI
Middle Name:
Last Name:ENCARNACION
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 1:58 FREEMAN ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-4005
Mailing Address - Country:US
Mailing Address - Phone:973-596-3975
Mailing Address - Fax:973-639-6583
Practice Address - Street 1:58 FREEMAN ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-4005
Practice Address - Country:US
Practice Address - Phone:973-596-3975
Practice Address - Fax:973-639-6583
Is Sole Proprietor?:No
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL057562001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical