Provider Demographics
NPI:1114005436
Name:DRUCKER, MONA MARIE (MA LPC)
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:MARIE
Last Name:DRUCKER
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 PALISADE RD
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-3833
Mailing Address - Country:US
Mailing Address - Phone:908-468-1008
Mailing Address - Fax:908-925-2897
Practice Address - Street 1:500 N WOOD AVE
Practice Address - Street 2:SUITE 2B
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-4160
Practice Address - Country:US
Practice Address - Phone:908-468-1008
Practice Address - Fax:908-925-2897
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00339900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional