Provider Demographics
NPI:1366671687
Name:REISS, JOANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:REISS
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 1:15 THORNBURY AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-2723
Mailing Address - Country:US
Mailing Address - Phone:201-652-5972
Mailing Address - Fax:
Practice Address - Street 1:410 RAMAPO VALLEY RD
Practice Address - Street 2:SUITE 203B
Practice Address - City:OAKLAND
Practice Address - State:NJ
Practice Address - Zip Code:07436-2735
Practice Address - Country:US
Practice Address - Phone:201-966-9392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2014-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054947001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical