Healthcare Provider Details

I. General information

NPI: 1396828026
Provider Name (Legal Business Name): SHOSHANA STOCKELBERG LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHOSHANA KAUFMAN LCSW

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 CEDAR LN
TEANECK NJ
07666-1709
US

IV. Provider business mailing address

75 E PARSONAGE WAY
MANALAPAN NJ
07726-7945
US

V. Phone/Fax

Practice location:
  • Phone: 732-547-5082
  • Fax:
Mailing address:
  • Phone: 732-547-5082
  • Fax: 732-431-4892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05276600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: