Healthcare Provider Details

I. General information

NPI: 1669962429
Provider Name (Legal Business Name): DANIELLE KIRSTEIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2018
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 SCHANCK RD STE A-6
FREEHOLD NJ
07728-2963
US

IV. Provider business mailing address

55 SCHANCK RD STE A-6
FREEHOLD NJ
07728-2963
US

V. Phone/Fax

Practice location:
  • Phone: 732-930-2242
  • Fax:
Mailing address:
  • Phone: 732-930-2242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06102800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: