Provider Demographics
NPI:1891370094
Name:OJO, JOSEPHINE E (LSW, MSW)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:E
Last Name:OJO
Suffix:
Gender:F
Credentials:LSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 IRVINE TURNER BLVD # 1
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07108-2415
Mailing Address - Country:US
Mailing Address - Phone:929-285-0532
Mailing Address - Fax:
Practice Address - Street 1:509 IRVINE TURNER BLVD # 1
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07108-2415
Practice Address - Country:US
Practice Address - Phone:929-285-0532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SLO6574900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0000Medicaid