Provider Demographics
NPI:1417034182
Name:REZNIK, ROBYN M (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:M
Last Name:REZNIK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:M
Other - Last Name:FAUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:270 STATE ROUTE 35
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5920
Mailing Address - Country:US
Mailing Address - Phone:732-842-2000
Mailing Address - Fax:732-224-0688
Practice Address - Street 1:270 STATE ROUTE 35
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5920
Practice Address - Country:US
Practice Address - Phone:732-842-2000
Practice Address - Fax:732-224-0688
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC047368001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical