Provider Demographics
NPI:1144514621
Name:SOBOL, BETH (MSW)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:
Last Name:SOBOL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 SADDLE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-1035
Mailing Address - Country:US
Mailing Address - Phone:732-834-9689
Mailing Address - Fax:
Practice Address - Street 1:20 SADDLE RIDGE RD
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-1035
Practice Address - Country:US
Practice Address - Phone:732-834-9689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05640001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical