Healthcare Provider Details

I. General information

NPI: 1053331819
Provider Name (Legal Business Name): ANNE K EFFRON MSW, LCSW, BCD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 05/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 CHANGEBRIDGE RD SUITE C-4
MONTVILLE NJ
07045-9115
US

IV. Provider business mailing address

39 STONEWALL DR
LIVINGSTON NJ
07039-1837
US

V. Phone/Fax

Practice location:
  • Phone: 973-794-6565
  • Fax: 973-794-3434
Mailing address:
  • Phone: 973-699-1207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05208800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: