Provider Demographics
NPI:1063628907
Name:GOLDBERG, JO-ANNE RZEPKA (LCSW)
Entity type:Individual
Prefix:MS
First Name:JO-ANNE
Middle Name:RZEPKA
Last Name:GOLDBERG
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 1:10 PRIMROSE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234
Mailing Address - Country:US
Mailing Address - Phone:609-432-3339
Mailing Address - Fax:609-463-0921
Practice Address - Street 1:10 PRIMROSE CIRCLE
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234
Practice Address - Country:US
Practice Address - Phone:609-432-3339
Practice Address - Fax:609-463-0921
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC001883001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJMAGELLAN HEALTHOther538608000