Provider Demographics
NPI:1811533920
Name:LANDSMAN, JAMIE ALEXANDRA (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:ALEXANDRA
Last Name:LANDSMAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:A
Other - Last Name:LANDSMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:6114 HAMILTON WAY
Mailing Address - Street 2:
Mailing Address - City:EASTAMPTON TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-1673
Mailing Address - Country:US
Mailing Address - Phone:732-503-9330
Mailing Address - Fax:
Practice Address - Street 1:6114 HAMILTON WAY
Practice Address - Street 2:
Practice Address - City:EASTAMPTON TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08060-1673
Practice Address - Country:US
Practice Address - Phone:732-503-9330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-24
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1138201041C0700X
AK2298321041C0700X
FLSW231941041C0700X
WVDP009468701041C0700X
NJ44SC060478001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX113820OtherLICENSED CLINICAL SOCIAL WORKER
AK229832OtherALASKA BOARD OF SOCIAL WORK
WVDP00946870OtherINDEPENDENT CLINICAL SOCIAL WORK LICENSE
FLSW23194OtherLICENSED CLINICAL SOCIAL WORKER