Provider Demographics
NPI:1386842060
Name:HEATON-COLELLA, MARGUERITE ROSE (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARGUERITE
Middle Name:ROSE
Last Name:HEATON-COLELLA
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:MARGUERITE
Other - Middle Name:ROSE
Other - Last Name:MAIN-HEATON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:646 W. OCEAN HEIGHTS AVENUE, SUITE 101
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221
Mailing Address - Country:US
Mailing Address - Phone:609-457-1769
Mailing Address - Fax:
Practice Address - Street 1:646 W. OCEAN HEIGHTS AVENUE, SUITE 101
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221
Practice Address - Country:US
Practice Address - Phone:609-457-1769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC046350001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical