Provider Demographics
NPI:1083821185
Name:BROTSKY, JULES BARRY (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JULES
Middle Name:BARRY
Last Name:BROTSKY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 MAPLEWOOD TERRACE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-2991
Mailing Address - Country:US
Mailing Address - Phone:732-364-7677
Mailing Address - Fax:732-364-7677
Practice Address - Street 1:721 W KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1255
Practice Address - Country:US
Practice Address - Phone:732-364-6060
Practice Address - Fax:732-364-6060
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC002064001041C0700X
NYPR01766811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
108882OtherVALUE OPTIONS
241626OtherCOMPSYCH
241626OtherCOMPSYCH