Provider Demographics
NPI:1790528131
Name:WALSMAN, REBECCA (MSW, LSW, LMSW, CTP)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:WALSMAN
Suffix:
Gender:F
Credentials:MSW, LSW, LMSW, CTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 MILLBURN AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1941
Mailing Address - Country:US
Mailing Address - Phone:973-913-4385
Mailing Address - Fax:
Practice Address - Street 1:96 MILLBURN AVE STE 101
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1941
Practice Address - Country:US
Practice Address - Phone:973-913-4385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120079-011041C0700X
NJ44SL068005001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical