Provider Demographics
NPI:1720833353
Name:HORN, ALISSA TAMAR (LMSW)
Entity Type:Individual
Prefix:
First Name:ALISSA
Middle Name:TAMAR
Last Name:HORN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ALISSA
Other - Middle Name:TAMAR
Other - Last Name:ROSENFELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:465 WINTHROP RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2969
Mailing Address - Country:US
Mailing Address - Phone:917-864-5701
Mailing Address - Fax:
Practice Address - Street 1:465 WINTHROP RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-2969
Practice Address - Country:US
Practice Address - Phone:917-864-5701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06628000104100000X
NY112534-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker