Provider Demographics
NPI:1417199381
Name:HUBER, MARY E (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:E
Last Name:HUBER
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 1:510 MORRIS AVE
Mailing Address - Street 2:TERRA SKY WELLNESS CENTER
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-1527
Mailing Address - Country:US
Mailing Address - Phone:973-224-0827
Mailing Address - Fax:908-277-1322
Practice Address - Street 1:510 MORRIS AVE
Practice Address - Street 2:TERRA SKY WELLNESS CENTER
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-1527
Practice Address - Country:US
Practice Address - Phone:973-224-0827
Practice Address - Fax:908-277-1322
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SCO52619001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical