Provider Demographics
NPI:1144599416
Name:GRESACK, LINDA (LCSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:GRESACK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:RITTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:152 TAMARACK CIRCLE
Mailing Address - Street 2:
Mailing Address - City:SKILLMAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08558-2021
Mailing Address - Country:US
Mailing Address - Phone:609-947-0492
Mailing Address - Fax:
Practice Address - Street 1:152 TAMARACK CIRCLE
Practice Address - Street 2:
Practice Address - City:SKILLMAN
Practice Address - State:NJ
Practice Address - Zip Code:08558-2021
Practice Address - Country:US
Practice Address - Phone:609-947-0492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-15
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC004388001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical