Healthcare Provider Details

I. General information

NPI: 1457385700
Provider Name (Legal Business Name): JEWISH FAMILY SERVICE & CHILDREN'S CENTER OF CLIFTON/PASSAIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 MAIN AVE
PASSAIC NJ
07055-4427
US

IV. Provider business mailing address

110 MAIN AVE
PASSAIC NJ
07055-4427
US

V. Phone/Fax

Practice location:
  • Phone: 973-777-7638
  • Fax: 973-777-9311
Mailing address:
  • Phone: 973-777-7638
  • Fax: 973-777-9311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberSC06729
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDER HERZOG
Title or Position: EXECUTIVE DIRECTOR
Credential: LCSW
Phone: 973-777-7638