Provider Demographics
NPI:1871075564
Name:BAUMGARTNER, STEPHANIE N (LCSW)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:N
Last Name:BAUMGARTNER
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 1:56 FOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:RINGWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07456-2411
Mailing Address - Country:US
Mailing Address - Phone:120-154-3906
Mailing Address - Fax:
Practice Address - Street 1:56 FOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:RINGWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07456-2411
Practice Address - Country:US
Practice Address - Phone:201-543-9064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC058044001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical