Provider Demographics
NPI:1639366438
Name:BASHOFF, CARRIE SPINDEL (PSYD)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:SPINDEL
Last Name:BASHOFF
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 NORTHFIELD AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1107
Mailing Address - Country:US
Mailing Address - Phone:201-791-2375
Mailing Address - Fax:
Practice Address - Street 1:743 NORTHFIELD AVENUE
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1107
Practice Address - Country:US
Practice Address - Phone:201-791-2375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100474600103TC0700X
NY016874103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent