Provider Demographics
NPI:1083744619
Name:FISCHBEIN, SUZAN E (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SUZAN
Middle Name:E
Last Name:FISCHBEIN
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 1:390 HILLSDALE AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07642
Mailing Address - Country:US
Mailing Address - Phone:201-263-9710
Mailing Address - Fax:201-666-4081
Practice Address - Street 1:390 HILLSDALE AVE
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:NJ
Practice Address - Zip Code:07642
Practice Address - Country:US
Practice Address - Phone:201-263-9710
Practice Address - Fax:201-666-4081
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC013738001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP2156007OtherOXFORD
NJ339310OtherVALUE OPTIONS
046332Medicare ID - Type Unspecified