Provider Demographics
NPI:1740520519
Name:ROTHLISBERGER, GENEVIEVE (LCSW)
Entity type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:
Last Name:ROTHLISBERGER
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 1:117-119 ROOSEVELT AVENUE
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-0331
Mailing Address - Country:US
Mailing Address - Phone:908-756-6870
Mailing Address - Fax:908-756-5566
Practice Address - Street 1:117-119 ROOSEVELT AVENUE
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-0331
Practice Address - Country:US
Practice Address - Phone:908-756-6870
Practice Address - Fax:908-756-5566
Is Sole Proprietor?:No
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055117001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical