Provider Demographics
NPI:1730700246
Name:ROSIECKI, RENEE NICOLE (DSW, LCSW, LCADC)
Entity type:Individual
Prefix:DR
First Name:RENEE
Middle Name:NICOLE
Last Name:ROSIECKI
Suffix:
Gender:F
Credentials:DSW, LCSW, LCADC
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:NICOLE
Other - Last Name:WALTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:221 RIVER ST STE 9
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-5990
Mailing Address - Country:US
Mailing Address - Phone:646-941-7645
Mailing Address - Fax:
Practice Address - Street 1:221 RIVER ST STE 9
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-5990
Practice Address - Country:US
Practice Address - Phone:646-941-7645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-06
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC059012001041C0700X
NJ37LC00315400101YA0400X
PACW0243031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)