Provider Demographics
NPI:1659915684
Name:STADTLANDER, TAYLOR J (LSW)
Entity Type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:J
Last Name:STADTLANDER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 OAKWOOD AVE APT B
Mailing Address - Street 2:
Mailing Address - City:NORTH HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-2421
Mailing Address - Country:US
Mailing Address - Phone:201-208-3669
Mailing Address - Fax:
Practice Address - Street 1:1 CHERRY LN
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1848
Practice Address - Country:US
Practice Address - Phone:201-934-1160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-02
Last Update Date:2019-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06493600104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker