Provider Demographics
NPI:1851811764
Name:BAMGBADE, JANET JOKE (LMSW)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:JOKE
Last Name:BAMGBADE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 RIVER RD APT J
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-3474
Mailing Address - Country:US
Mailing Address - Phone:609-658-3939
Mailing Address - Fax:
Practice Address - Street 1:21 RIVER ROAD
Practice Address - Street 2:APT. J
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110
Practice Address - Country:US
Practice Address - Phone:609-658-3939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-21
Last Update Date:2023-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10039-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker