Provider Demographics
NPI:1396045852
Name:KRASSNER, BARBARA HERMS (MSW LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:HERMS
Last Name:KRASSNER
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:MS
Other - First Name:BONNIE
Other - Middle Name:
Other - Last Name:KRASSNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW LCSW
Mailing Address - Street 1:16 ROSSMORE TER
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-3018
Mailing Address - Country:US
Mailing Address - Phone:973-422-9100
Mailing Address - Fax:973-322-9936
Practice Address - Street 1:50 NORTHFIELD AVE
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-5320
Practice Address - Country:US
Practice Address - Phone:973-422-9100
Practice Address - Fax:973-322-9936
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC007611001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1943BROOKLYNMedicare PIN