Provider Demographics
NPI:1689886434
Name:SICHERMAN, JOAN R (MSW LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:R
Last Name:SICHERMAN
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:FANE
Other - Last Name:SICHERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW LCSW
Mailing Address - Street 1:152 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CRANBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08512
Mailing Address - Country:US
Mailing Address - Phone:609-655-4151
Mailing Address - Fax:609-395-8498
Practice Address - Street 1:152 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CRANBURY
Practice Address - State:NJ
Practice Address - Zip Code:08512
Practice Address - Country:US
Practice Address - Phone:609-655-4151
Practice Address - Fax:609-395-8498
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJSC048001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA145435OtherVALUE OPTIONS