Provider Demographics
NPI:1427747013
Name:GALLANTER, REBECCA (MSW, LSW)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:
Last Name:GALLANTER
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:MENDELSSOHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LSW
Mailing Address - Street 1:40 FROST AVE
Mailing Address - Street 2:
Mailing Address - City:E BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4504
Mailing Address - Country:US
Mailing Address - Phone:732-794-9824
Mailing Address - Fax:732-390-1790
Practice Address - Street 1:590 WESTFIELD AVE STE 6
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-3312
Practice Address - Country:US
Practice Address - Phone:908-666-6380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL04506200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker