Provider Demographics
NPI:1215343900
Name:ALTER, JEAN (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:JEAN
Middle Name:
Last Name:ALTER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CYPRESS AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-4019
Mailing Address - Country:US
Mailing Address - Phone:973-768-1231
Mailing Address - Fax:
Practice Address - Street 1:55 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-2225
Practice Address - Country:US
Practice Address - Phone:908-347-6211
Practice Address - Fax:908-242-3392
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-02
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ000616131041S0200X
NJ44SC001297001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool