Provider Demographics
NPI:1477693521
Name:ERBACH, DANIEL J (LCSW)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:J
Last Name:ERBACH
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ESSEX ST APT A4
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-2643
Mailing Address - Country:US
Mailing Address - Phone:551-697-5352
Mailing Address - Fax:
Practice Address - Street 1:6 ESSEX ST APT A4
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-2643
Practice Address - Country:US
Practice Address - Phone:862-201-3180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC059560001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty