Provider Demographics
NPI:1538361639
Name:GREENWALD, CAREN (MSW)
Entity type:Individual
Prefix:MS
First Name:CAREN
Middle Name:
Last Name:GREENWALD
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 1:91 EMERSON STREET
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013
Mailing Address - Country:US
Mailing Address - Phone:973-278-4128
Mailing Address - Fax:973-423-9580
Practice Address - Street 1:546 HIGH MOUNTAIN ROAD
Practice Address - Street 2:
Practice Address - City:NORTH HALEDON
Practice Address - State:NJ
Practice Address - Zip Code:07508
Practice Address - Country:US
Practice Address - Phone:973-278-4128
Practice Address - Fax:973-423-9580
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC00281100104100000X
NJ37FI00120500106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
644033Medicare ID - Type Unspecified