Provider Demographics
NPI:1346590114
Name:EISNER, MARTHA C (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:C
Last Name:EISNER
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 1:270 BROADWAY
Mailing Address - Street 2:MONMOUTH FAMILY HEALTH CENTER
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-7027
Mailing Address - Country:US
Mailing Address - Phone:732-923-7102
Mailing Address - Fax:
Practice Address - Street 1:270 BROADWAY
Practice Address - Street 2:MONMOUTH FAMILY HEALTH CENTER
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-7027
Practice Address - Country:US
Practice Address - Phone:732-923-7102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054998001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical