Provider Demographics
NPI:1821503053
Name:ESPOSITO, PATRICIA (LCSW, CDVC, CCBT)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:ESPOSITO
Suffix:
Gender:F
Credentials:LCSW, CDVC, CCBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:534 CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-3230
Mailing Address - Country:US
Mailing Address - Phone:973-777-6490
Mailing Address - Fax:973-777-6491
Practice Address - Street 1:534 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-3230
Practice Address - Country:US
Practice Address - Phone:973-777-6490
Practice Address - Fax:973-777-6491
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-11
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY074542-11041C0700X
NJ44SC057717001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty