Provider Demographics
NPI:1821008004
Name:FUTRAN, TAMARA L (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:L
Last Name:FUTRAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 SHERWOOD PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:MOUNTAINSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07092-2512
Mailing Address - Country:US
Mailing Address - Phone:908-232-8399
Mailing Address - Fax:908-232-8399
Practice Address - Street 1:608 SHERWOOD PKWY
Practice Address - Street 2:
Practice Address - City:MOUNTAINSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07092-2512
Practice Address - Country:US
Practice Address - Phone:908-232-8399
Practice Address - Fax:908-232-8399
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC000948001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical