Provider Demographics
NPI:1346531795
Name:STRAUSS-RUSSO, DONNA M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:M
Last Name:STRAUSS-RUSSO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:DONNA
Other - Middle Name:M
Other - Last Name:STRAUSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:155 COUNTY RD
Mailing Address - Street 2:SUITE 14
Mailing Address - City:CRESSKILL
Mailing Address - State:NJ
Mailing Address - Zip Code:07626-2200
Mailing Address - Country:US
Mailing Address - Phone:201-788-3122
Mailing Address - Fax:
Practice Address - Street 1:155 COUNTY RD
Practice Address - Street 2:SUITE 14
Practice Address - City:CRESSKILL
Practice Address - State:NJ
Practice Address - Zip Code:07626-2200
Practice Address - Country:US
Practice Address - Phone:201-788-3122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-20
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054362001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0856291Medicaid