Healthcare Provider Details

I. General information

NPI: 1487336475
Provider Name (Legal Business Name): CAROL BERMAN SW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

300 FOREST AVE # A
PARAMUS NJ
07652-5429
US

IV. Provider business mailing address

10 STONEY HILL PL
LIVINGSTON NJ
07039-3720
US

V. Phone/Fax

Practice location:
  • Phone: 201-490-5158
  • Fax: 201-696-3955
Mailing address:
  • Phone: 302-526-4547
  • Fax: 302-469-2115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06228000
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: