Provider Demographics
NPI:1790421196
Name:FAINES, RONALD (LCADC)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:
Last Name:FAINES
Suffix:
Gender:M
Credentials:LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 EAST NORTHFIELD ROAD
Mailing Address - Street 2:SUITE LL5
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039
Mailing Address - Country:US
Mailing Address - Phone:973-251-2874
Mailing Address - Fax:973-251-2878
Practice Address - Street 1:349 EAST NORTHFIELD ROAD
Practice Address - Street 2:SUITE LL5
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039
Practice Address - Country:US
Practice Address - Phone:973-251-2874
Practice Address - Fax:973-251-2878
Is Sole Proprietor?:No
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00148800101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)