Provider Demographics
NPI:1730474123
Name:MCSORLEY, TARA NORA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:NORA
Last Name:MCSORLEY
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 1:39 ZELIFF PL
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-2014
Mailing Address - Country:US
Mailing Address - Phone:973-294-4199
Mailing Address - Fax:
Practice Address - Street 1:37 KINGS RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-2500
Practice Address - Country:US
Practice Address - Phone:973-294-4199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054404001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical