Provider Demographics
NPI:1730212200
Name:MENAHEM, SUSAN J (LCSW)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:J
Last Name:MENAHEM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-4901
Mailing Address - Country:US
Mailing Address - Phone:732-897-1529
Mailing Address - Fax:
Practice Address - Street 1:8 S 3RD AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-2510
Practice Address - Country:US
Practice Address - Phone:732-246-8439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052607001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical