Provider Demographics
NPI:1750681102
Name:ESTRIN, LISA (LCSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:ESTRIN
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 1:70 HILLTOP RD
Mailing Address - Street 2:SUITE 1004
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1155
Mailing Address - Country:US
Mailing Address - Phone:201-327-0005
Mailing Address - Fax:201-327-0157
Practice Address - Street 1:70 HILLTOP RD
Practice Address - Street 2:SUITE 1004
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1155
Practice Address - Country:US
Practice Address - Phone:201-327-0005
Practice Address - Fax:201-327-0157
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC001248001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical