Healthcare Provider Details

I. General information

NPI: 1811929565
Provider Name (Legal Business Name): NORMA SHARON MCCOBIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

336 W PASSAIC ST 4TH FL
ROCHELLE PARK NJ
07662-3027
US

IV. Provider business mailing address

75 CHARNWOOD RD
NEW PROVIDENCE NJ
07974-1768
US

V. Phone/Fax

Practice location:
  • Phone: 201-845-7030
  • Fax:
Mailing address:
  • Phone: 908-665-0267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC01383800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: