Provider Demographics
NPI:1447364575
Name:EPSTEIN, EILEEN A (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:A
Last Name:EPSTEIN
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 NEWPORT PKWY
Mailing Address - Street 2:110
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07310-1518
Mailing Address - Country:US
Mailing Address - Phone:201-626-3399
Mailing Address - Fax:201-626-3399
Practice Address - Street 1:40 NEWPORT PKWY
Practice Address - Street 2:110
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07310-1518
Practice Address - Country:US
Practice Address - Phone:201-626-3399
Practice Address - Fax:201-626-3399
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC000814001041C0700X
NYR034046-11041C0700X
NJ37FI00115400106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist