Provider Demographics
NPI:1407075872
Name:RUBENFELD-WALDRON, JAYNE (MSSW,LCSW)
Entity Type:Individual
Prefix:MS
First Name:JAYNE
Middle Name:
Last Name:RUBENFELD-WALDRON
Suffix:
Gender:F
Credentials:MSSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 PIERMONT RD
Mailing Address - Street 2:
Mailing Address - City:CLOSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07624-1533
Mailing Address - Country:US
Mailing Address - Phone:201-750-0303
Mailing Address - Fax:201-750-0752
Practice Address - Street 1:20 PIERMONT RD
Practice Address - Street 2:
Practice Address - City:CLOSTER
Practice Address - State:NJ
Practice Address - Zip Code:07624-1533
Practice Address - Country:US
Practice Address - Phone:201-750-0303
Practice Address - Fax:201-750-0752
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC003046001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical