Provider Demographics
NPI:1598733529
Name:GOLDSTEIN, STACIE L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:STACIE
Middle Name:L
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:STACIE
Other - Middle Name:L
Other - Last Name:GOLDSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:184 RIVER VALE RD
Mailing Address - Street 2:
Mailing Address - City:RIVERVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-6270
Mailing Address - Country:US
Mailing Address - Phone:201-232-9828
Mailing Address - Fax:201-664-3077
Practice Address - Street 1:184 RIVER VALE RD
Practice Address - Street 2:
Practice Address - City:RIVERVALE
Practice Address - State:NJ
Practice Address - Zip Code:07675-6270
Practice Address - Country:US
Practice Address - Phone:201-232-9828
Practice Address - Fax:201-664-3077
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052748001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical