Provider Demographics
NPI:1013065432
Name:JOHN F MCINERNEY PHD LLC
Entity Type:Organization
Organization Name:JOHN F MCINERNEY PHD LLC
Other - Org Name:CAPE BEHAVIORAL HEALTH GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:MCINERNEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:609-463-1662
Mailing Address - Street 1:211 S MAIN STREET
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-2264
Mailing Address - Country:US
Mailing Address - Phone:609-463-1662
Mailing Address - Fax:609-463-1658
Practice Address - Street 1:211 S MAIN STREET
Practice Address - Street 2:SUITE 301
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2264
Practice Address - Country:US
Practice Address - Phone:609-463-1662
Practice Address - Fax:609-463-1658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI01232103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ092944Medicare ID - Type Unspecified