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General NPI Number Information
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NPI Number | 1366671687
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Entity Type | Individual
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Provider Name | JOANNE REISS LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/08/2009
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Last Update Date | 07/26/2014
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Provider Practice Location Address
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Address Line | 410 RAMAPO VALLEY RD SUITE 203B
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City | OAKLAND
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State | NJ
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Zip | 07436-2735
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Country | US
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Telephone | 201-966-9392
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Fax |
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Provider Business Mailing Address
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Address Line | 15 THORNBURY AVE
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City | GLEN ROCK
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State | NJ
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Zip | 07452-2723
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Country | US
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Telephone | 201-652-5972
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05494700
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License Number State | NJ
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