Provider Demographics
NPI:1902178809
Name:IBRAHIM-ROSARIO, NAJAT (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NAJAT
Middle Name:
Last Name:IBRAHIM-ROSARIO
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 1:1111 CLIFTON AVENUE, SUITE 202
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013
Mailing Address - Country:US
Mailing Address - Phone:973-223-6607
Mailing Address - Fax:973-983-5935
Practice Address - Street 1:1111 CLIFTON AVENUE, SUITE 202
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013
Practice Address - Country:US
Practice Address - Phone:973-223-6607
Practice Address - Fax:973-983-5935
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-08
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055687001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0665126Medicaid
NJ4138601Medicaid