Provider Demographics
NPI:1649402587
Name:ANGEL MCRAE, DORIS (MFT,LPC,LRC)
Entity Type:Individual
Prefix:MRS
First Name:DORIS
Middle Name:
Last Name:ANGEL MCRAE
Suffix:
Gender:F
Credentials:MFT,LPC,LRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CAMPBELL DR STE 205
Mailing Address - Street 2:
Mailing Address - City:WILLINGBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08046-1068
Mailing Address - Country:US
Mailing Address - Phone:609-505-2927
Mailing Address - Fax:856-385-7178
Practice Address - Street 1:200 CAMPBELL DR STE 205
Practice Address - Street 2:
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046-1068
Practice Address - Country:US
Practice Address - Phone:609-505-2927
Practice Address - Fax:856-385-7178
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37RC00243400101YA0400X, 101YM0800X
NJ37PC00233500101YP2500X, 106H00000X
NJ00170349101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist