Provider Demographics
NPI:1053413096
Name:GREENBERG, RONNIE S (MSW LCSW)
Entity type:Individual
Prefix:MS
First Name:RONNIE
Middle Name:S
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 LIVINGSTON RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-1352
Mailing Address - Country:US
Mailing Address - Phone:908-838-0195
Mailing Address - Fax:
Practice Address - Street 1:747 LIVINGSTON RD
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-1352
Practice Address - Country:US
Practice Address - Phone:908-838-0195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC00584000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
P2866502OtherOXFORD
CA000197OtherST BARNABUS HEALTH SYSTEM
186000OtherMHN
232073OtherCOMPSYCH
UBH3088929228OtherVALUE
460341A783714OtherOPTIONS
7334601OtherGHI
9394585OtherPHC
9394585OtherPHC