Provider Demographics
NPI:1366021768
Name:MACIAS, SOFIA (LPC, LCADC)
Entity Type:Individual
Prefix:MS
First Name:SOFIA
Middle Name:
Last Name:MACIAS
Suffix:
Gender:F
Credentials:LPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-93 ROUTE 23 POMPTON AVENUE
Mailing Address - Street 2:PMB 1011
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009-2205
Mailing Address - Country:US
Mailing Address - Phone:973-370-4343
Mailing Address - Fax:
Practice Address - Street 1:91 POMPTON AVE
Practice Address - Street 2:
Practice Address - City:CEDAR GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07009-2013
Practice Address - Country:US
Practice Address - Phone:973-370-4343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00703300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional