Provider Demographics
NPI:1609929140
Name:NOLAN, THOMAS JAMES JR (MSW)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:JAMES
Last Name:NOLAN
Suffix:JR
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 RTE 17 NORTH
Mailing Address - Street 2:SUITE 313
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2644
Mailing Address - Country:US
Mailing Address - Phone:201-368-2626
Mailing Address - Fax:201-368-0055
Practice Address - Street 1:12 ST HWY 17 N
Practice Address - Street 2:SUITE 313
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2644
Practice Address - Country:US
Practice Address - Phone:201-368-2626
Practice Address - Fax:201-368-0055
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC013897001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical