Provider Demographics
NPI:1164472940
Name:RZETELNY, SANDRA (LCSW)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:RZETELNY
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 1:121 CEDAR LN
Mailing Address - Street 2:STE 3C
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4457
Mailing Address - Country:US
Mailing Address - Phone:201-410-2226
Mailing Address - Fax:201-569-4340
Practice Address - Street 1:121 CEDAR LN
Practice Address - Street 2:STE 3C
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4457
Practice Address - Country:US
Practice Address - Phone:201-410-2226
Practice Address - Fax:201-569-4340
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC051782001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical