Healthcare Provider Details

I. General information

NPI: 1811533920
Provider Name (Legal Business Name): JAMIE ALEXANDRA LANDSMAN MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JAMIE A LANDSMAN MSW, LCSW

II. Dates (important events)

Enumeration Date: 11/24/2019
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6114 HAMILTON WAY
EASTAMPTON TOWNSHIP NJ
08060-1673
US

IV. Provider business mailing address

6114 HAMILTON WAY
EASTAMPTON TOWNSHIP NJ
08060-1673
US

V. Phone/Fax

Practice location:
  • Phone: 732-503-9330
  • Fax:
Mailing address:
  • Phone: 732-503-9330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number113820
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number229832
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW23194
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberDP00946870
License Number StateWV
# 5
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06047800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: