Provider Demographics
NPI:1972595817
Name:RUANE, MARY ANNE (MSW, LCSW, CADC)
Entity Type:Individual
Prefix:MS
First Name:MARY ANNE
Middle Name:
Last Name:RUANE
Suffix:
Gender:F
Credentials:MSW, LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 BROAD ST
Mailing Address - Street 2:SUITE 2E
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-2003
Mailing Address - Country:US
Mailing Address - Phone:732-747-4333
Mailing Address - Fax:743-747-0095
Practice Address - Street 1:268 BROAD ST
Practice Address - Street 2:SUITE 2E
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-2003
Practice Address - Country:US
Practice Address - Phone:732-747-4333
Practice Address - Fax:743-747-0095
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC000867001041C0700X
NJ37CA00025900101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
638799Medicare ID - Type Unspecified