Provider Demographics
NPI:1679009120
Name:SHETH, NISHITA (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:NISHITA
Middle Name:
Last Name:SHETH
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 S 10TH AVE
Mailing Address - Street 2:APARTMENT B
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-3116
Mailing Address - Country:US
Mailing Address - Phone:609-836-2736
Mailing Address - Fax:
Practice Address - Street 1:107 CEDAR GROVE LN
Practice Address - Street 2:SUITE 100
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-4719
Practice Address - Country:US
Practice Address - Phone:609-836-2736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-03
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05884700104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker