Provider Demographics
NPI:1770941031
Name:KAUFMAN, MILTON A (LCSW)
Entity type:Individual
Prefix:
First Name:MILTON
Middle Name:A
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 GRAND AVE APT 2B
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-4638
Mailing Address - Country:US
Mailing Address - Phone:201-960-1604
Mailing Address - Fax:
Practice Address - Street 1:25 GRAND AVE APT 2B
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-4638
Practice Address - Country:US
Practice Address - Phone:201-960-1604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-02
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FLSW154821041C0700X
NJ44SC058382001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health