Provider Demographics
NPI:1881080885
Name:CESPEDES, ROSALIE (LSW)
Entity type:Individual
Prefix:MS
First Name:ROSALIE
Middle Name:
Last Name:CESPEDES
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:ROSALIA
Other - Middle Name:
Other - Last Name:CESPEDES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:523 LYSTER AVE
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-5909
Mailing Address - Country:US
Mailing Address - Phone:201-790-8219
Mailing Address - Fax:
Practice Address - Street 1:622 VALLEY RD STE 5E
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043
Practice Address - Country:US
Practice Address - Phone:201-790-8219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-07
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06042800104100000X
NJ44SC057904001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker