Provider Demographics
NPI:1275667727
Name:MCGUIRE, MARISA DEVITO (LCSW)
Entity Type:Individual
Prefix:
First Name:MARISA
Middle Name:DEVITO
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 VILLAGE CT
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1532
Mailing Address - Country:US
Mailing Address - Phone:732-759-0881
Mailing Address - Fax:
Practice Address - Street 1:270 HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5920
Practice Address - Country:US
Practice Address - Phone:732-842-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055298001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical