Provider Demographics
NPI:1023340387
Name:FECHNER, ROBERT BRETT (LCSW)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:BRETT
Last Name:FECHNER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 COOPER AVE
Mailing Address - Street 2:SUITE 5B
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-1883
Mailing Address - Country:US
Mailing Address - Phone:646-246-7135
Mailing Address - Fax:
Practice Address - Street 1:209 COOPER AVE
Practice Address - Street 2:SUITE 5B
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-1883
Practice Address - Country:US
Practice Address - Phone:646-246-7135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052774001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical