Most Relevant Information
Provider Data
| NPI Number: | 1003196023 |
| Provider Name: | LISSA CAPTAIN MSW, LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 44SC05310100 |
Most Important Dates
| Enumeration Date: | 08/22/2011 |
| Last Updated: | 02/23/2014 |
Provider Practice Location
294 HARRINGTON AVE
CLOSTER
NJ
076241912
Practice Location Phone/Fax
| Phone: | 9736509078 |
| Fax: |
Provider Mailing Location
200 SUSSEX ST
PATERSON
NJ
075032722
Provider Mailing Phone/Fax
| Phone: | 9736509078 |
| Fax: |