Provider Demographics
NPI:1457051260
Name:KUSHNIR, LAUREN (MSW, LSW, CDP, CSWHC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:KUSHNIR
Suffix:
Gender:F
Credentials:MSW, LSW, CDP, CSWHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:563 CROSS ST
Mailing Address - Street 2:
Mailing Address - City:TOWNSHIP OF WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07676-4330
Mailing Address - Country:US
Mailing Address - Phone:201-638-9569
Mailing Address - Fax:
Practice Address - Street 1:563 CROSS ST
Practice Address - Street 2:
Practice Address - City:TOWNSHIP OF WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07676-4330
Practice Address - Country:US
Practice Address - Phone:201-638-9569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY094867104100000X
171M00000X
NJ44SL05956100104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator