Provider Demographics
NPI:1669080016
Name:ZISSLER, MEGAN J (LSW)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:J
Last Name:ZISSLER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FORDS
Mailing Address - State:NJ
Mailing Address - Zip Code:08863-1738
Mailing Address - Country:US
Mailing Address - Phone:732-491-1930
Mailing Address - Fax:
Practice Address - Street 1:151 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:FORDS
Practice Address - State:NJ
Practice Address - Zip Code:08863-1738
Practice Address - Country:US
Practice Address - Phone:732-491-1930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06290200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker