MEDICARE: REBECA TABAK 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	44SL06530800	NJ

General Provider Information

NPI Number	:	1578442406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECA TABAK LCSW

Provider Business Mailing Address
First Line	:	4 ASHFORD RD
Second Line	:
City	:	JACKSON
State	:	NJ
Zip	:	08527-1702
Country	:	US
Telephone Number	:	347-988-9735
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 ASHFORD RD
Second Line	:
City	:	JACKSON
State	:	NJ
Zip	:	08527-1702
Country	:	US
Telephone Number	:	347-988-9735
Fax Number	:

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

Provider Enumeration Date	:	08/27/2025
Last Update Date	:	08/27/2025

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Directions to “ REBECA TABAK LCSW” Practice Location

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