Provider Demographics
NPI:1023427325
Name:RUSSO-BARRETT, TONI (LCSW)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:RUSSO-BARRETT
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 1:40 RAVINE AVE
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-4813
Mailing Address - Country:US
Mailing Address - Phone:201-306-4374
Mailing Address - Fax:
Practice Address - Street 1:40 RAVINE AVE
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-4813
Practice Address - Country:US
Practice Address - Phone:201-306-4374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-12
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054822001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical