Provider Demographics
NPI:1417172305
Name:ROTHCHILD, NANCY PHYLLIS (MSSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:PHYLLIS
Last Name:ROTHCHILD
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 RYNDA RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1465
Mailing Address - Country:US
Mailing Address - Phone:973-763-8081
Mailing Address - Fax:
Practice Address - Street 1:160 S LIVINGSTON AVE
Practice Address - Street 2:SUITE 113
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-3033
Practice Address - Country:US
Practice Address - Phone:973-763-1315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC014219001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical