Healthcare Provider Details

I. General information

NPI: 1831680560
Provider Name (Legal Business Name): NESHAMA MARCUS LCSW, LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2018
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 VERONICA AVE STE 201
SOMERSET NJ
08873-5002
US

IV. Provider business mailing address

629 CRANBURY RD FL 2
EAST BRUNSWICK NJ
08816-4096
US

V. Phone/Fax

Practice location:
  • Phone: 732-246-4882
  • Fax: 732-249-5633
Mailing address:
  • Phone: 732-390-7750
  • Fax: 732-390-7725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SL05651700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: