Lisette Diaz, LCSW
Social Worker, Clinical in Rutherford, NJ. Individual provider (NPI-1).
NPI number1689083099
StatusActive
Last updated in NPPESOct 18, 2023
Details
- NPI
- 1689083099
- Entity type
- Individual (NPI-1)
- Name
- Lisette Diaz
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 11, 2014
- Certification date
- Mar 15, 2023
- Last updated
- Oct 18, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 44SC06095800 | NJ | Yes |
Practice location
29 Morse AveRutherford, NJ 07070-1250
Phone 201-450-7455
Mailing address
29 Morse AveRutherford, NJ 07070-1250
Phone 201-450-7455
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