Provider Demographics
NPI:1457798464
Name:OSBORNE, MONICA (LCSW)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:OSBORNE
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 1:181 N 11TH ST APT 203
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-1142
Mailing Address - Country:US
Mailing Address - Phone:973-454-8002
Mailing Address - Fax:
Practice Address - Street 1:181 N 11TH ST
Practice Address - Street 2:SUITE 404
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-1100
Practice Address - Country:US
Practice Address - Phone:973-454-8002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2022-08-22
Deactivation Date:2014-09-16
Deactivation Code:
Reactivation Date:2014-11-13
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NY0802631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical