Provider Demographics
NPI:1992121164
Name:NINA F. RIFKIND, LCSW, LLC
Entity type:Organization
Organization Name:NINA F. RIFKIND, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NINA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIFKIND
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:973-216-4405
Mailing Address - Street 1:76 BROADWAY
Mailing Address - Street 2:SUITE 200E
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2764
Mailing Address - Country:US
Mailing Address - Phone:973-216-4405
Mailing Address - Fax:973-784-4234
Practice Address - Street 1:76 BROADWAY
Practice Address - Street 2:SUITE 200E
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2764
Practice Address - Country:US
Practice Address - Phone:973-216-4405
Practice Address - Fax:973-784-4234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-12
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ260734OtherMEDICARE PTAN