Provider Demographics
NPI:1659311173
Name:NERENBERG, ELISE S (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ELISE
Middle Name:S
Last Name:NERENBERG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:ELISE
Other - Middle Name:S
Other - Last Name:NERENBERG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:131 VAN HOUTEN AVE
Mailing Address - Street 2:FLOOR 2
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-4601
Mailing Address - Country:US
Mailing Address - Phone:862-290-1700
Mailing Address - Fax:
Practice Address - Street 1:284 HIGH ST
Practice Address - Street 2:FLOOR 2
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-3402
Practice Address - Country:US
Practice Address - Phone:862-290-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052813001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical