Provider Demographics
NPI:1558058982
Name:CAMILO, JOSLYN (LSW)
Entity Type:Individual
Prefix:
First Name:JOSLYN
Middle Name:
Last Name:CAMILO
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 1:301 1ST PL
Mailing Address - Street 2:
Mailing Address - City:BOGOTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07603-1318
Mailing Address - Country:US
Mailing Address - Phone:551-221-6246
Mailing Address - Fax:
Practice Address - Street 1:604 SHERWOOD PKWY
Practice Address - Street 2:
Practice Address - City:MOUNTAINSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07092-2519
Practice Address - Country:US
Practice Address - Phone:908-663-5687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06881700104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker