Provider Demographics
NPI:1225167547
Name:TANA, MARGARET ANN (LPC,LCADC)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:ANN
Last Name:TANA
Suffix:
Gender:F
Credentials:LPC,LCADC
Other - Prefix:MS
Other - First Name:PEGGY
Other - Middle Name:
Other - Last Name:TANA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC,LCADC
Mailing Address - Street 1:170 KINNELON RD RM 14M
Mailing Address - Street 2:
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-2324
Mailing Address - Country:US
Mailing Address - Phone:973-838-7265
Mailing Address - Fax:
Practice Address - Street 1:170 KINNELON RD RM 14M
Practice Address - Street 2:
Practice Address - City:KINNELON
Practice Address - State:NJ
Practice Address - Zip Code:07405-2324
Practice Address - Country:US
Practice Address - Phone:973-838-7265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00078800101YA0400X
NJ37PC00302700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP3479872OtherOXFORD INSURANCE ID