Provider Demographics
NPI:1619062452
Name:MAHLER, BETH F (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:F
Last Name:MAHLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 WANAQUE AVE
Mailing Address - Street 2:SUITE 5-2ND FLOOR
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442-1844
Mailing Address - Country:US
Mailing Address - Phone:201-214-7898
Mailing Address - Fax:973-807-1904
Practice Address - Street 1:342 HAMBURG TPKE
Practice Address - Street 2:SUITE 201
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2162
Practice Address - Country:US
Practice Address - Phone:973-389-9085
Practice Address - Fax:973-389-9086
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC04748500104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
089353Medicare ID - Type Unspecified