Dayna Bandman

Individual provider Active NPI Clinical Social Worker · Upper Montclair, NJ

NPI 1285841809 · NPPES record last updated Jan 21, 2016

Key facts

NPI
1285841809
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
44SC05275275100 (NJ)
Practice address
209 Cooper Ave
Ste 5C
Upper Montclair, NJ 07043-1850
Phone
(973) 509-2955
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
44SC05275275100NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Services Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC05275275100 NJ Yes

Addresses

Primary practice location

209 Cooper Ave
Ste 5C
Upper Montclair, NJ 07043-1850

Mailing address

120 Cooper Ave
Montclair, NJ 07043-2219

Other providers in Upper Montclair, NJ

All providers in Upper Montclair, NJ · Clinical Social Worker in New Jersey

Sources for this page

Verify at the official NPI Registry.