Michelle Certosimo, LCSW

Individual provider Active NPI Clinical Social Worker · Ramsey, NJ

NPI 1720535511 · NPPES record last updated Nov 11, 2019

Key facts

NPI
1720535511
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
44SC05853200 (NJ)
Practice address
400D Lake St Ste 2
Ramsey, NJ 07446-1279
Phone
(201) 739-6489
NPI assigned
Sep 8, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
44SC05853200NJMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC05853200 NJ Yes

Addresses

Primary practice location

400D Lake St Ste 2
Ramsey, NJ 07446-1279

Mailing address

130 S Mahwah Rd
Mahwah, NJ 07430-1859
Phone (201) 739-6489

Other providers in Ramsey, NJ

All providers in Ramsey, NJ · Clinical Social Worker in New Jersey

Sources for this page

Verify at the official NPI Registry.