Provider Demographics
NPI:1295892677
Name:MACARIN-MARA, LYNN MARCIA (LCSW,CSW,)
Entity type:Individual
Prefix:MS
First Name:LYNN
Middle Name:MARCIA
Last Name:MACARIN-MARA
Suffix:
Gender:F
Credentials:LCSW,CSW,
Other - Prefix:MRS
Other - First Name:LYNN
Other - Middle Name:MACARIN
Other - Last Name:WEINGAST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW,
Mailing Address - Street 1:2 BLAIR AVE
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2003
Mailing Address - Country:US
Mailing Address - Phone:732-906-6383
Mailing Address - Fax:732-906-5429
Practice Address - Street 1:633 CLOVE RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-2736
Practice Address - Country:US
Practice Address - Phone:732-906-6383
Practice Address - Fax:732-906-5429
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC006044001041C0700X
NYPRO256981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ44SC00604400OtherLCSW
NYPRO25698OtherLCSW
NYPRO25698OtherLCSW
NYN55683Medicare ID - Type Unspecified