Provider Demographics
NPI:1033343488
Name:JORDAN FELDMAN, SHARON E (MSW)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:E
Last Name:JORDAN FELDMAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23 POTTER AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-9777
Mailing Address - Country:US
Mailing Address - Phone:973-786-5913
Mailing Address - Fax:973-786-5913
Practice Address - Street 1:17 WOODPORT RD
Practice Address - Street 2:SUITE 2C
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-1933
Practice Address - Country:US
Practice Address - Phone:973-786-5913
Practice Address - Fax:973-786-5913
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC005837001041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
153743Medicare PIN