Provider Demographics
NPI:1194861161
Name:WALDMAN, SUZANNE ROSE (MA, LPC, BCC, ACS)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:ROSE
Last Name:WALDMAN
Suffix:
Gender:F
Credentials:MA, LPC, BCC, ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 215
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-0215
Mailing Address - Country:US
Mailing Address - Phone:973-857-9090
Mailing Address - Fax:
Practice Address - Street 1:25 BROOKDALE AVE
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-2429
Practice Address - Country:US
Practice Address - Phone:973-857-9090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002141101YM0800X
NJ37PC00103300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health