Provider Demographics
NPI:1629163795
Name:GREENBERG, RICK (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:
Last Name:GREENBERG
Suffix:
Gender:M
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-3538
Mailing Address - Country:US
Mailing Address - Phone:201-791-1824
Mailing Address - Fax:201-794-9294
Practice Address - Street 1:120 W 57TH ST
Practice Address - Street 2:JBFCS
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3320
Practice Address - Country:US
Practice Address - Phone:212-632-4633
Practice Address - Fax:212-307-7896
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0281601041C0700X
NJ1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical