Provider Demographics
NPI:1679685283
Name:MCNAMARA, ANNE CAMILLE (LCADC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:CAMILLE
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:566 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-5325
Mailing Address - Country:US
Mailing Address - Phone:732-450-2689
Mailing Address - Fax:732-450-2803
Practice Address - Street 1:48 E FRONT ST
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1823
Practice Address - Country:US
Practice Address - Phone:732-450-2689
Practice Address - Fax:732-450-2803
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00037400101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)