Provider Demographics
NPI:1609065838
Name:LINDAUER, JEROME (LCSW, LSW)
Entity Type:Individual
Prefix:MR
First Name:JEROME
Middle Name:
Last Name:LINDAUER
Suffix:
Gender:M
Credentials:LCSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7437 OVERHILL RD
Mailing Address - Street 2:
Mailing Address - City:MELROSE PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-3326
Mailing Address - Country:US
Mailing Address - Phone:267-474-3201
Mailing Address - Fax:215-635-5202
Practice Address - Street 1:2999 PRINCETON PIKE
Practice Address - Street 2:SUITE 6
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-3261
Practice Address - Country:US
Practice Address - Phone:267-474-3201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005612E104100000X
NJ44SC013679001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker