Provider Demographics
NPI:1922301092
Name:GLADYS F MARI LLC
Entity Type:Organization
Organization Name:GLADYS F MARI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICSENED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:F
Authorized Official - Last Name:MARI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-818-0303
Mailing Address - Street 1:40 BEY LEA RD
Mailing Address - Street 2:SUITE B201
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2900
Mailing Address - Country:US
Mailing Address - Phone:732-818-0303
Mailing Address - Fax:
Practice Address - Street 1:40 BEY LEA RD
Practice Address - Street 2:SUITE B201
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2900
Practice Address - Country:US
Practice Address - Phone:732-818-0303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty