Provider Demographics
NPI:1376964585
Name:GARSON, MARC H (LCSW, MSW, MSM)
Entity Type:Individual
Prefix:MR
First Name:MARC
Middle Name:H
Last Name:GARSON
Suffix:
Gender:M
Credentials:LCSW, MSW, MSM
Other - Prefix:MR
Other - First Name:MARCOS
Other - Middle Name:H
Other - Last Name:GARSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW, MSW, MSM
Mailing Address - Street 1:516 PLEASANT VALLEY WAY
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-2833
Mailing Address - Country:US
Mailing Address - Phone:973-412-2056
Mailing Address - Fax:
Practice Address - Street 1:274 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2419
Practice Address - Country:US
Practice Address - Phone:973-412-2056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053935001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical