Provider Demographics
NPI:1528087657
Name:BENGAL, PHYLLIS PLESSER (LCSW)
Entity type:Individual
Prefix:MRS
First Name:PHYLLIS
Middle Name:PLESSER
Last Name:BENGAL
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 1:323 ORENDA CIR
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-2915
Mailing Address - Country:US
Mailing Address - Phone:908-654-7869
Mailing Address - Fax:908-654-0542
Practice Address - Street 1:151 KNOLLCROFT RD
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:LYONS
Practice Address - State:NJ
Practice Address - Zip Code:07939-5001
Practice Address - Country:US
Practice Address - Phone:908-647-0180
Practice Address - Fax:908-604-5266
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC048180001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical