Provider Demographics
NPI:1205997228
Name:BARON, MARILYN (LCSW, LCADC)
Entity type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:
Last Name:BARON
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 WEST END AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-1828
Mailing Address - Country:US
Mailing Address - Phone:908-725-9939
Mailing Address - Fax:908-566-3345
Practice Address - Street 1:73 WEST END AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-1828
Practice Address - Country:US
Practice Address - Phone:908-725-9939
Practice Address - Fax:908-566-3345
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2009-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00046900101YA0400X
NJ44SC046265001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ488719OtherVALUE OPTIONS
NJ522384475OtherCIGNA
NJ522384475OtherHORIZON BLUE CROSS
NJ0007681479OtherAETNA
NJ522384475OtherTRI-CARE
NJ266789000OtherMAGELLAN BEHAVIORAL
NJ277615OtherMHN
NJ522384475OtherTRI-CARE