Provider Demographics
NPI:1518068899
Name:SCHUCK, MARGARET CANNIN
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:CANNIN
Last Name:SCHUCK
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MIDGE
Other - Middle Name:CANNIN
Other - Last Name:SCHUCK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:1133 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08757-2608
Mailing Address - Country:US
Mailing Address - Phone:732-286-2501
Mailing Address - Fax:732-286-2501
Practice Address - Street 1:1133 7TH AVE
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08757-2608
Practice Address - Country:US
Practice Address - Phone:732-286-2501
Practice Address - Fax:732-286-2501
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00337900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0094544Medicaid