Provider Demographics
NPI:1417014416
Name:SOFFER, JEFFREY STANLEY (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:STANLEY
Last Name:SOFFER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 APRIL WAY
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-6510
Mailing Address - Country:US
Mailing Address - Phone:201-894-8318
Mailing Address - Fax:201-871-4775
Practice Address - Street 1:407 APRIL WAY
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748-6510
Practice Address - Country:US
Practice Address - Phone:201-894-8318
Practice Address - Fax:201-871-4775
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2023-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC 083881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJSC 08388OtherNJ LICENSE
NJP536670OtherOXFORD INS PROVIDER #
NYR 014757OtherLCSW NEW YORK LICENSE
NJ221726712OtherGROUP PRACTICE TAX ID
NJSC 08388OtherNJ LICENSE