Provider Demographics
NPI:1043535321
Name:NEWMAN, WENDY GAVIN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:GAVIN
Last Name:NEWMAN
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 1:6 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-4312
Mailing Address - Country:US
Mailing Address - Phone:973-228-4624
Mailing Address - Fax:
Practice Address - Street 1:103 PARK ST
Practice Address - Street 2:BLDG B
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-5913
Practice Address - Country:US
Practice Address - Phone:973-228-4624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-30
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054754001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical