Provider Demographics
NPI:1467519603
Name:SCHLADT, MARY BETH (LPC, LCADC)
Entity Type:Individual
Prefix:MS
First Name:MARY BETH
Middle Name:
Last Name:SCHLADT
Suffix:
Gender:F
Credentials:LPC, LCADC
Other - Prefix:
Other - First Name:MARY BETH
Other - Middle Name:
Other - Last Name:SCHLADT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, LCADC
Mailing Address - Street 1:92 BROADWAY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2761
Mailing Address - Country:US
Mailing Address - Phone:973-283-4538
Mailing Address - Fax:
Practice Address - Street 1:92 BROADWAY
Practice Address - Street 2:SUITE 104
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2761
Practice Address - Country:US
Practice Address - Phone:973-283-4538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00108700101YA0400X
NJ37PC00168500101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)