Provider Demographics
NPI:1396848099
Name:LEHMANN, NAN R (MSW LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NAN
Middle Name:R
Last Name:LEHMANN
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:MISS
Other - First Name:NAN
Other - Middle Name:
Other - Last Name:ROTHENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW RCSW LCSW
Mailing Address - Street 1:579 WEST ENGLEWOOD AVENUE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2939
Mailing Address - Country:US
Mailing Address - Phone:201-836-4239
Mailing Address - Fax:201-836-5228
Practice Address - Street 1:579 WEST ENGLEWOOD AVENUE
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-2939
Practice Address - Country:US
Practice Address - Phone:201-836-4239
Practice Address - Fax:201-836-5228
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ445C004836001041C0700X
NYR00419311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ640636Medicare ID - Type Unspecified