Provider Demographics
NPI:1578339925
Name:JOHANNAROSENFIELD LLC
Entity Type:Organization
Organization Name:JOHANNAROSENFIELD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOHANNA
Authorized Official - Middle Name:W
Authorized Official - Last Name:ROSENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-457-8502
Mailing Address - Street 1:PO BOX 43611
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-0611
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:209 COOPER AVE STE 5D
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-1850
Practice Address - Country:US
Practice Address - Phone:973-457-8502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty