Provider Demographics
NPI:1770990996
Name:ROTHBART, SHARON (LCSW)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:ROTHBART
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 NOTTING HILL WAY
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2475
Mailing Address - Country:US
Mailing Address - Phone:201-448-0018
Mailing Address - Fax:
Practice Address - Street 1:1119 RARITAN AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-3639
Practice Address - Country:US
Practice Address - Phone:732-246-8439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057280001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical