Provider Demographics
NPI:1093270787
Name:SCHRAM, STEPHEN (LSW)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:SCHRAM
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-3818
Mailing Address - Country:US
Mailing Address - Phone:201-339-9200
Mailing Address - Fax:201-339-5401
Practice Address - Street 1:601 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3818
Practice Address - Country:US
Practice Address - Phone:201-339-9200
Practice Address - Fax:201-339-5401
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-06
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC059912001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical