Provider Demographics
NPI:1437585502
Name:KURZNER, ANDREA (LCSW, ACSW, BCD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:KURZNER
Suffix:
Gender:F
Credentials:LCSW, ACSW, BCD
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:NUDELMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANDREA NUDELMAN
Mailing Address - Street 1:368 ESSEX ST FL 2
Mailing Address - Street 2:
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1330
Mailing Address - Country:US
Mailing Address - Phone:917-239-4529
Mailing Address - Fax:
Practice Address - Street 1:368 ESSEX ST FL 2
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1330
Practice Address - Country:US
Practice Address - Phone:917-239-4529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-20
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY083048104100000X
NJ44SC056276001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker