Healthcare Provider Details

I. General information

NPI: 1851444897
Provider Name (Legal Business Name): LEAH KAUFMAN MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 02/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PIKE DR
WAYNE NJ
07470-2443
US

IV. Provider business mailing address

9-02 6TH ST
FAIR LAWN NJ
07410-6104
US

V. Phone/Fax

Practice location:
  • Phone: 973-595-0111
  • Fax: 973-595-5477
Mailing address:
  • Phone: 201-794-2123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number44SC00198900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC00198900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: