Provider Demographics
NPI:1356649628
Name:TRYBA, JANICE G (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:G
Last Name:TRYBA
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:
Other - Last Name:MULHOLLEM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:104-110 MAPLE AVE
Mailing Address - Street 2:RIVER RUN BLDG
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701
Mailing Address - Country:US
Mailing Address - Phone:732-740-7115
Mailing Address - Fax:
Practice Address - Street 1:104-110 MAPLE AVE
Practice Address - Street 2:RIVER RUN BLDG
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701
Practice Address - Country:US
Practice Address - Phone:732-740-7115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC00391700104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker