Provider Demographics
NPI:1982931549
Name:EISENBERG, WENDY G (LCSW)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:G
Last Name:EISENBERG
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 1:10 N 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-2419
Mailing Address - Country:US
Mailing Address - Phone:732-246-1010
Mailing Address - Fax:732-565-9001
Practice Address - Street 1:10 N 2ND AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-2419
Practice Address - Country:US
Practice Address - Phone:732-246-1010
Practice Address - Fax:732-565-9001
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC048891001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical