Provider Demographics
NPI:1740992734
Name:ERDMAN, MICHELLE CHRISTINE (LSW)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:CHRISTINE
Last Name:ERDMAN
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 1:5 GLENGORRA CT
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-1512
Mailing Address - Country:US
Mailing Address - Phone:551-777-1801
Mailing Address - Fax:
Practice Address - Street 1:63 MILLTOWN RD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-2378
Practice Address - Country:US
Practice Address - Phone:732-659-0683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06894800104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker