Provider Demographics
NPI:1952470940
Name:BURGER, JUDITH MIRIAM (LCSW, PSYD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:MIRIAM
Last Name:BURGER
Suffix:
Gender:F
Credentials:LCSW, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ADELPHI TRL
Mailing Address - Street 2:
Mailing Address - City:HOPATCONG
Mailing Address - State:NJ
Mailing Address - Zip Code:07843-1745
Mailing Address - Country:US
Mailing Address - Phone:973-398-3733
Mailing Address - Fax:973-398-3733
Practice Address - Street 1:11 ADELPHI TRL
Practice Address - Street 2:
Practice Address - City:HOPATCONG
Practice Address - State:NJ
Practice Address - Zip Code:07843-1745
Practice Address - Country:US
Practice Address - Phone:973-398-3733
Practice Address - Fax:973-398-3733
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC015231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJSC01523OtherCERTIFIED SOCIAL WORKER