Medino, Elisabeth Mary

Medino, Elisabeth Mary is an individual health care provider with primary practice located at 38 Chestnut Ave , Pompton Lakes NJ 07442-2406. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Medino, Elisabeth Mary can be contacted via phone (973) 907-4908.

Contact Information

Primary practice address
38 Chestnut Ave Pompton Lakes NJ 07442-2406
Phone: (973) 907-4908
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 44SL06073800 New Jersey
Behavioral Health & Social Service Providers / Clinical 1041C0700X 44SC05963500 New Jersey

Profile Details

NPI number 1396247342
LBN Legal business name Medino, Elisabeth Mary
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 6th, 2018
Last updated Feb 18th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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