Provider Demographics
NPI:1477798874
Name:GREENSPUN, AIDA LOPEZ (LCSW)
Entity Type:Individual
Prefix:MS
First Name:AIDA
Middle Name:LOPEZ
Last Name:GREENSPUN
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:PO BOX 844
Mailing Address - Street 2:
Mailing Address - City:MILLTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08850-0844
Mailing Address - Country:US
Mailing Address - Phone:732-257-2023
Mailing Address - Fax:
Practice Address - Street 1:32 SOUTH DR
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-1133
Practice Address - Country:US
Practice Address - Phone:732-735-1596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-14
Last Update Date:2008-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC014694001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical