Provider Demographics
NPI:1861285967
Name:HARTUNG RISPOLI, HEIDI
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:HARTUNG RISPOLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 ACKERMAN RD
Mailing Address - Street 2:
Mailing Address - City:SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-2602
Mailing Address - Country:US
Mailing Address - Phone:551-427-0027
Mailing Address - Fax:
Practice Address - Street 1:215 E RIDGEWOOD AVE STE 204
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3826
Practice Address - Country:US
Practice Address - Phone:551-284-3373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06993100104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker