Provider Demographics
NPI:1578740189
Name:CESPEDES-SANTACRUZ, JOSEFINA (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:JOSEFINA
Middle Name:
Last Name:CESPEDES-SANTACRUZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:JOSEFINA
Other - Middle Name:
Other - Last Name:CESPEDES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1372 SUMMER ST STE 207
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5361
Mailing Address - Country:US
Mailing Address - Phone:203-539-0133
Mailing Address - Fax:
Practice Address - Street 1:1372 SUMMER ST STE 207
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5361
Practice Address - Country:US
Practice Address - Phone:203-539-0133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-25
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
102X00000X, 101YP1600X
CT6144104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No102X00000XBehavioral Health & Social Service ProvidersPoetry Therapist
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral