Provider Demographics
NPI:1447412671
Name:JAMES, SHANTE (LCSW)
Entity Type:Individual
Prefix:
First Name:SHANTE
Middle Name:
Last Name:JAMES
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:PO BOX 1383
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-0383
Mailing Address - Country:US
Mailing Address - Phone:732-814-0764
Mailing Address - Fax:732-626-8889
Practice Address - Street 1:617 UNION AVE
Practice Address - Street 2:BLDG 3, SUITE 20
Practice Address - City:BRIELLE
Practice Address - State:NJ
Practice Address - Zip Code:08730-1838
Practice Address - Country:US
Practice Address - Phone:732-814-0764
Practice Address - Fax:732-626-8886
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053318001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical