Provider Demographics
NPI:1609291186
Name:DEMOTT, MARCUS (MSW, LSW)
Entity Type:Individual
Prefix:MR
First Name:MARCUS
Middle Name:
Last Name:DEMOTT
Suffix:
Gender:M
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 NORTH CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08609
Mailing Address - Country:US
Mailing Address - Phone:609-394-5751
Mailing Address - Fax:
Practice Address - Street 1:39 N CLINTON AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08609-1011
Practice Address - Country:US
Practice Address - Phone:609-394-5751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL057585001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical