Provider Demographics
NPI:1609992353
Name:KAPLAN, PHYLLIS MONA (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:MONA
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-1072
Mailing Address - Country:US
Mailing Address - Phone:973-361-8565
Mailing Address - Fax:973-361-0059
Practice Address - Street 1:24 GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-1072
Practice Address - Country:US
Practice Address - Phone:973-945-1509
Practice Address - Fax:973-361-0059
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC001378001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical