Provider Demographics
NPI:1376604058
Name:KAFTAN, ESTA K (LCSW)
Entity Type:Individual
Prefix:
First Name:ESTA
Middle Name:K
Last Name:KAFTAN
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 1:2115 MILLBURN AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-3724
Mailing Address - Country:US
Mailing Address - Phone:973-420-6251
Mailing Address - Fax:908-228-5363
Practice Address - Street 1:2115 MILLBURN AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-3724
Practice Address - Country:US
Practice Address - Phone:973-420-6251
Practice Address - Fax:908-228-5363
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC047870000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health