Healthcare Provider Details

I. General information

NPI: 1902009129
Provider Name (Legal Business Name): RACHEL MAX SICHERMAN L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RACHEL KRUPNICK

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 MAIN RD SUITE 100
MONTVILLE NJ
07045-9231
US

IV. Provider business mailing address

137 MAIN RD SUITE 100
MONTVILLE NJ
07045-9231
US

V. Phone/Fax

Practice location:
  • Phone: 973-634-5043
  • Fax:
Mailing address:
  • Phone: 973-634-5043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL04690600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05763200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: