Provider Demographics
NPI:1417506924
Name:CAJUSTE, ENGLIDE (CLINICAL SOCIAL WORK)
Entity Type:Individual
Prefix:
First Name:ENGLIDE
Middle Name:
Last Name:CAJUSTE
Suffix:
Gender:F
Credentials:CLINICAL SOCIAL WORK
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 LANDVALE RD
Mailing Address - Street 2:
Mailing Address - City:SPOTSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08884-1713
Mailing Address - Country:US
Mailing Address - Phone:908-468-9325
Mailing Address - Fax:
Practice Address - Street 1:727 FRANKLIN BLVD
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3624
Practice Address - Country:US
Practice Address - Phone:732-619-0392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC058762001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty