Individual
MS. ELANA B. BLUMENTHAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
65 N MAPLE AVE STE 200, RIDGEWOOD, NJ 07450-3233
(201) 960-1812
Mailing address
0-32 E AMSTERDAM AVE, FAIR LAWN, NJ 07410-4632
(201) 791-8689
(201) 458-0895
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05238100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44SC05238100
SOCIAL WORK LICENSE
NJ
Enumeration date
05/10/2007
Last updated
01/18/2008
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