Provider Demographics
NPI:1740588458
Name:GRATZ, JAMES HUGH (LCSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:HUGH
Last Name:GRATZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BUCKINGHAM AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-3311
Mailing Address - Country:US
Mailing Address - Phone:609-392-6349
Mailing Address - Fax:
Practice Address - Street 1:5 BUCKINGHAM AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-3311
Practice Address - Country:US
Practice Address - Phone:609-392-6349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SCO50687001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical