Provider Demographics
NPI:1851444897
Name:KAUFMAN, LEAH (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:LEAH
Middle Name:
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9-02 6TH ST
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-6104
Mailing Address - Country:US
Mailing Address - Phone:201-794-2123
Mailing Address - Fax:
Practice Address - Street 1:1 PIKE DR
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2443
Practice Address - Country:US
Practice Address - Phone:973-595-0111
Practice Address - Fax:973-595-5477
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC00198900171M00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ44SC00198900OtherLCSW LICENSE
NJ44SC00198900OtherLCSW LICENSE