Provider Demographics
NPI:1316360266
Name:ZELMAN, CRYSTAL L (LCSW, CCLS, RPT)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:L
Last Name:ZELMAN
Suffix:
Gender:F
Credentials:LCSW, CCLS, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 BROADWAY
Mailing Address - Street 2:SUITE 200H
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2764
Mailing Address - Country:US
Mailing Address - Phone:862-242-0559
Mailing Address - Fax:
Practice Address - Street 1:76 BROADWAY
Practice Address - Street 2:SUITE 200H
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2764
Practice Address - Country:US
Practice Address - Phone:862-242-0559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054626001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical