Provider Demographics
NPI:1912475831
Name:ZISHOLTZ, JOSHUA (LCSW)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:ZISHOLTZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 RYNDA RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1463
Mailing Address - Country:US
Mailing Address - Phone:310-592-7584
Mailing Address - Fax:
Practice Address - Street 1:32 RYNDA RD
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-1463
Practice Address - Country:US
Practice Address - Phone:310-592-7584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-08
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC06152001041C0700X
NY0936331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical