Healthcare Provider Details

I. General information

NPI: 1972379170
Provider Name (Legal Business Name): SHEILA BERARD LCSW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2023
Last Update Date: 11/29/2023
Certification Date: 11/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 FOREST AVE STE 209
PARAMUS NJ
07652-5238
US

IV. Provider business mailing address

PO BOX 186
GLEN ROCK NJ
07452-0186
US

V. Phone/Fax

Practice location:
  • Phone: 201-240-9176
  • Fax:
Mailing address:
  • Phone: 201-240-9176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SHEILA BERARD
Title or Position: OWNER, CLINICIAN
Credential: LCSW
Phone: 201-240-9176