Provider Demographics
NPI:1629320015
Name:BICKART, JOHN M (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:M
Last Name:BICKART
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 WOODMERE AVE
Mailing Address - Street 2:
Mailing Address - City:INTERLAKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-4328
Mailing Address - Country:US
Mailing Address - Phone:732-221-2625
Mailing Address - Fax:
Practice Address - Street 1:509 WOODMERE AVE
Practice Address - Street 2:
Practice Address - City:INTERLAKEN
Practice Address - State:NJ
Practice Address - Zip Code:07712-4328
Practice Address - Country:US
Practice Address - Phone:732-361-7275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-09
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05731200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker