Provider Demographics
NPI:1336789288
Name:BESS, DAVID EARL (MSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:EARL
Last Name:BESS
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 LYNWOOD PL
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940-1117
Mailing Address - Country:US
Mailing Address - Phone:862-812-1222
Mailing Address - Fax:
Practice Address - Street 1:8 LYNWOOD PL
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-1117
Practice Address - Country:US
Practice Address - Phone:862-812-1222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44LS01425400104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ44LS01425400OtherNJBSWE