Provider Demographics
NPI:1265069298
Name:MAGUIRE, JAMES J
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:MAGUIRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 WILKINS RD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-4767
Mailing Address - Country:US
Mailing Address - Phone:609-273-1641
Mailing Address - Fax:
Practice Address - Street 1:51 WILKINS RD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-4767
Practice Address - Country:US
Practice Address - Phone:609-273-1641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00040300101Y00000X
101Y00000X
37PC00040300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ37PC00040300OtherSTATE OF NEW JERSEY LICENSE NUMBER