Provider Demographics
NPI:1740050814
Name:GUREVITCH, CHANA (LMSW)
Entity type:Individual
Prefix:
First Name:CHANA
Middle Name:
Last Name:GUREVITCH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CHANA
Other - Middle Name:
Other - Last Name:SCHERMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:31 SHAYAS RD BSMT
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5564
Mailing Address - Country:US
Mailing Address - Phone:848-329-3156
Mailing Address - Fax:
Practice Address - Street 1:216 RIVER AVE STE 213
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4807
Practice Address - Country:US
Practice Address - Phone:848-329-3156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06963400104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker