=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841670247
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MELANIE LESTER LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/02/2015
-----------------------------------------------------
Last Update Date | 06/02/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | ONE PIKE DRIVE JEWISH FAMILY SERVICE OF NORTH JERSEY
-----------------------------------------------------
City | WAYNE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07470
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 934-595-0111
-----------------------------------------------------
Fax | 973-595-5477
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 78 STONE RUN RD
-----------------------------------------------------
City | BEDMINSTER
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07921-1710
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-234-1211
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 44SC05632800
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------