=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922304096
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHELLE K HAAR MSW, LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/07/2011
-----------------------------------------------------
Last Update Date | 02/07/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15 ALDEN ST SUITE 10
-----------------------------------------------------
City | CRANFORD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07016-2149
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-216-4724
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7 VILLAGE CIR
-----------------------------------------------------
City | WESTFIELD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07090-3626
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
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 | 44SC04911400
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------