Provider Demographics
NPI:1649252032
Name:BRANDT, DAVID I (LCSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:I
Last Name:BRANDT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:551 VALLEY RD
Mailing Address - Street 2:PMB 190
Mailing Address - City:UPPER MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-1832
Mailing Address - Country:US
Mailing Address - Phone:973-783-7940
Mailing Address - Fax:973-783-7940
Practice Address - Street 1:51 UPPER MONTCLAIR PLZ
Practice Address - Street 2:RM. 12
Practice Address - City:UPPER MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-1343
Practice Address - Country:US
Practice Address - Phone:973-746-1933
Practice Address - Fax:973-783-7940
Is Sole Proprietor?:No
Enumeration Date:2005-11-19
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC045089001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical