Provider Demographics
NPI:1023159241
Name:RUNFOLA, JOAN FRAMO (MSSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:FRAMO
Last Name:RUNFOLA
Suffix:
Gender:F
Credentials:MSSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-2110
Mailing Address - Country:US
Mailing Address - Phone:201-341-2351
Mailing Address - Fax:888-800-0201
Practice Address - Street 1:658 RIDGEWOOD RD
Practice Address - Street 2:#8
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-2536
Practice Address - Country:US
Practice Address - Phone:201-341-2351
Practice Address - Fax:888-800-0201
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC005272001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP3663356OtherOXFORD PROVIDER ID NUMBER
NJ169386Medicare PIN