MEDICARE: SUSAN W. SCHECHTER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	44SC10291000	NJ

General Provider Information

NPI Number	:	1528119120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN W. SCHECHTER LCSW

Provider Business Mailing Address
First Line	:	21 WARFIELD ST
Second Line	:
City	:	MONTCLAIR
State	:	NJ
Zip	:	07043-1107
Country	:	US
Telephone Number	:	973-746-9079
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 MORRIS AVE
Second Line	:
City	:	SPRINGFIELD
State	:	NJ
Zip	:	07081-1027
Country	:	US
Telephone Number	:	973-467-3300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	07/08/2007

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