Provider Demographics
NPI:1770237729
Name:DURR, CERISSA (LCSW LCADC)
Entity Type:Individual
Prefix:
First Name:CERISSA
Middle Name:
Last Name:DURR
Suffix:
Gender:F
Credentials:LCSW LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 MILLBURN AVE STE 7
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1023
Mailing Address - Country:US
Mailing Address - Phone:908-447-1017
Mailing Address - Fax:
Practice Address - Street 1:28 MILLBURN AVE STE 7
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1023
Practice Address - Country:US
Practice Address - Phone:908-447-1017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00329700101YA0400X
NJ44SC062587001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)