Provider Demographics
NPI:1225893811
Name:MCRAE, DEBBIE (LSW)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:
Last Name:MCRAE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 STATE ROUTE 34 STE 301
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-3485
Mailing Address - Country:US
Mailing Address - Phone:732-858-1533
Mailing Address - Fax:
Practice Address - Street 1:1000 STATE ROUTE 34
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-3473
Practice Address - Country:US
Practice Address - Phone:732-858-1533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05934600104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker