Individual provider · NPI-1

Kimberly C Agresta, LCSW

Social Worker, Clinical · Hackensack, NJ

NPI number1235308925
StatusActive
Last updated in NPPESFeb 27, 2008

Details

NPI
1235308925
Entity type
Individual (NPI-1)
Name
Kimberly C Agresta
Credential
LCSW
Sex
Female
Sole proprietor
Yes
Enumeration date
Feb 27, 2008
Last updated
Feb 27, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical44SC05347700NJYes

Practice location

547 Main Street
Hackensack, NJ 07601

Phone 201-784-6718

Mailing address

4 Blackledge Ct
Closter, NJ 07624

Phone 201-784-6718

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