Provider Demographics
NPI:1083755094
Name:GOTTLIEB, RIKKI BONNIE (MSW LCSW)
Entity Type:Individual
Prefix:MRS
First Name:RIKKI
Middle Name:BONNIE
Last Name:GOTTLIEB
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 CRAIG RD
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3274
Mailing Address - Country:US
Mailing Address - Phone:732-845-2800
Mailing Address - Fax:
Practice Address - Street 1:116 CRAIG RD
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3274
Practice Address - Country:US
Practice Address - Phone:732-845-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC045328001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical