Provider Demographics
NPI:1457555724
Name:BRITO, EILEEN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:
Last Name:BRITO
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 1:160 MENDHAM RD E
Mailing Address - Street 2:
Mailing Address - City:MENDHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07945-3015
Mailing Address - Country:US
Mailing Address - Phone:570-994-2664
Mailing Address - Fax:570-694-6694
Practice Address - Street 1:745 MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-2060
Practice Address - Country:US
Practice Address - Phone:570-994-2664
Practice Address - Fax:570-694-6694
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0156461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA317284ZH4OtherMEDICARE PTAN
PA1029180700001Medicaid