Provider Demographics
NPI:1114516937
Name:BENNETT, ERIN MEGHAN (LCSW)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MEGHAN
Last Name:BENNETT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:MEGHAN
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:15 CLAUSS RD
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-1610
Mailing Address - Country:US
Mailing Address - Phone:732-877-5598
Mailing Address - Fax:
Practice Address - Street 1:15 CLAUSS RD APT SUITE
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-1610
Practice Address - Country:US
Practice Address - Phone:732-877-5598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC058208001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical