Provider Demographics
NPI:1205233343
Name:SALZMAN, STEPHEN JONATHAN (LAC)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:JONATHAN
Last Name:SALZMAN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1848
Mailing Address - Country:US
Mailing Address - Phone:201-841-8329
Mailing Address - Fax:
Practice Address - Street 1:1 CHERRY LN
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1848
Practice Address - Country:US
Practice Address - Phone:201-841-8329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-03
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00226000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health