Provider Demographics
NPI: | 1558979005 |
---|---|
Name: | MAHER, JAMES J III (LCSW, LCADC) |
Entity Type: | Individual |
Prefix: | MR |
First Name: | JAMES |
Middle Name: | J |
Last Name: | MAHER |
Suffix: | III |
Gender: | M |
Credentials: | LCSW, LCADC |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 44 STEINER AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | HAMILTON |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 08619-1621 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 609-937-0768 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 905 HERRONTOWN RD |
Practice Address - Street 2: | |
Practice Address - City: | PRINCETON |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 08540-1901 |
Practice Address - Country: | US |
Practice Address - Phone: | 609-937-0768 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2020-07-21 |
Last Update Date: | 2023-01-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NJ | 37LC00361900 | 101YA0400X |
NJ | 44SC06132500 | 1041C0700X |
NJ | SW-GTL-20-01182 | 104100000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 104100000X | Behavioral Health & Social Service Providers | Social Worker | |
No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical |