Provider Demographics
NPI:1780635060
Name:PADWAL, MARYJANE MINDY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARYJANE
Middle Name:MINDY
Last Name:PADWAL
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 1:860 LOWER FERRY RD
Mailing Address - Street 2:3K
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08628-3525
Mailing Address - Country:US
Mailing Address - Phone:609-771-8082
Mailing Address - Fax:609-882-9151
Practice Address - Street 1:865 LOWER FERRY RD
Practice Address - Street 2:B9
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08628-3517
Practice Address - Country:US
Practice Address - Phone:609-882-9151
Practice Address - Fax:609-882-9151
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC000914001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA709434Medicare ID - Type UnspecifiedMEDICARE ID