Provider Demographics
NPI:1699910521
Name:BESS, JUDITH D (LCSW)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:D
Last Name:BESS
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 1:8 LYNWOOD PL
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940-1117
Mailing Address - Country:US
Mailing Address - Phone:973-454-0728
Mailing Address - Fax:
Practice Address - Street 1:100 KINGS RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-2670
Practice Address - Country:US
Practice Address - Phone:973-454-0728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-05
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC0147762001041C0700X
NY050670-R1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical