Healthcare Provider Details

I. General information

NPI: 1316035108
Provider Name (Legal Business Name): MARILYN KAPLAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 BROAD ST
BLOOMFIELD NJ
07003-2605
US

IV. Provider business mailing address

250 RIDGEDALE AVE APT N2 UNIT N-2
FLORHAM PARK NJ
07932-1333
US

V. Phone/Fax

Practice location:
  • Phone: 201-572-8057
  • Fax:
Mailing address:
  • Phone: 201-572-8057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number444SC01462600
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: