Jonathan S Byrne, LCSW

Individual provider Active NPI Clinical Social Worker · Closter, NJ

NPI 1154790400 · NPPES record last updated Jul 13, 2017

Key facts

NPI
1154790400
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
44SC05676000 (NJ)
Practice address
294 Harrington Ave
Suite #6
Closter, NJ 07624-1912
Phone
(201) 564-7331
NPI assigned
Sep 16, 2015
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

State licenses

LicenseStateTypeSpecialty
44SC05676000NJMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC05676000 NJ Yes

Addresses

Primary practice location

294 Harrington Ave
Suite #6
Closter, NJ 07624-1912

Mailing address

64 Claremont Ave
(Optional)
Bloomfield, NJ 07003-3035
Phone (201) 674-0702

Other providers in Closter, NJ

All providers in Closter, NJ · Clinical Social Worker in New Jersey

Sources for this page

Verify at the official NPI Registry.