Provider Demographics
NPI:1497293096
Name:KRUTYANSKY, ALLA (MSW, LSW)
Entity Type:Individual
Prefix:MRS
First Name:ALLA
Middle Name:
Last Name:KRUTYANSKY
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 E RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:JAMESBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-1207
Mailing Address - Country:US
Mailing Address - Phone:973-561-8555
Mailing Address - Fax:
Practice Address - Street 1:79 E RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:JAMESBURG
Practice Address - State:NJ
Practice Address - Zip Code:08831-1207
Practice Address - Country:US
Practice Address - Phone:732-561-8555
Practice Address - Fax:973-836-0349
Is Sole Proprietor?:No
Enumeration Date:2017-02-03
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06214700101YM0800X, 103TB0200X, 103TC0700X, 103TF0000X, 103TP2701X, 106H00000X, 103TC2200X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist