Provider Demographics
NPI:1790319614
Name:MAURICE, WILLIAM FREDERICK (LPC, LCADC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:FREDERICK
Last Name:MAURICE
Suffix:
Gender:M
Credentials:LPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:CRESSKILL
Mailing Address - State:NJ
Mailing Address - Zip Code:07626-1231
Mailing Address - Country:US
Mailing Address - Phone:201-561-3500
Mailing Address - Fax:
Practice Address - Street 1:1060 MAIN ST STE 303
Practice Address - Street 2:
Practice Address - City:RIVER EDGE
Practice Address - State:NJ
Practice Address - Zip Code:07661-2592
Practice Address - Country:US
Practice Address - Phone:201-488-0408
Practice Address - Fax:201-488-0411
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-29
Last Update Date:2020-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00462500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional