Lindsay Brooke Kestenbaum
Individual provider Active NPI Social Worker · Demarest, NJ
NPI 1083419972 · NPPES record last updated Feb 15, 2025
Key facts
- NPI
- 1083419972
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 126101 (NY)
- Practice address
- 109 Lake Rd
Demarest, NJ 07627-1223 - Phone
- (201) 921-1882
- NPI assigned
- Feb 15, 2025
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker |
104100000X | 126101 | NY | Yes |
Addresses
Primary practice location
109 Lake Rd
Demarest, NJ 07627-1223
Mailing address
109 Lake Rd
Demarest, NJ 07627-1223
Other providers in Demarest, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.