Provider Demographics
NPI:1255821393
Name:PASSMAN, MICHELE B (LCSW)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:B
Last Name:PASSMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 MONROE ST APT 407
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-6295
Mailing Address - Country:US
Mailing Address - Phone:908-216-5509
Mailing Address - Fax:
Practice Address - Street 1:900 MONROE ST APT 407
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-6295
Practice Address - Country:US
Practice Address - Phone:908-216-5509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057643001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical