Provider Demographics
NPI:1437249745
Name:GUTSTEIN, EILEEN (MSW,LCSW,LMFT)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:
Last Name:GUTSTEIN
Suffix:
Gender:F
Credentials:MSW,LCSW,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 MAXWELL LN
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-2935
Mailing Address - Country:US
Mailing Address - Phone:732-780-7391
Mailing Address - Fax:732-294-4795
Practice Address - Street 1:69 MAXWELL LN
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-2935
Practice Address - Country:US
Practice Address - Phone:732-780-7391
Practice Address - Fax:732-294-4795
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC001558001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P1132311OtherOXFORD INSURANCE NUMBER
015185OtherVALUE OPTIONS INSURANCE
0034991OtherGHI HEALTH INSURANCE NUMB
0034991OtherGHI HEALTH INSURANCE NUMB