Provider Demographics
NPI:1780736652
Name:THALER, HARRIET S (LICENSED CLINICAL SO)
Entity type:Individual
Prefix:MRS
First Name:HARRIET
Middle Name:S
Last Name:THALER
Suffix:
Gender:F
Credentials:LICENSED CLINICAL SO
Other - Prefix:MRS
Other - First Name:HARRIET
Other - Middle Name:RAYNES
Other - Last Name:THALER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW LMFT
Mailing Address - Street 1:5 PLEASANT VIEW WAY
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-4617
Mailing Address - Country:US
Mailing Address - Phone:908-788-5136
Mailing Address - Fax:908-782-8930
Practice Address - Street 1:3461 RT 22 EAST
Practice Address - Street 2:
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876-6021
Practice Address - Country:US
Practice Address - Phone:908-704-9434
Practice Address - Fax:908-253-0141
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC003051041C0700X
NJ1222106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TH637357Medicare ID - Type Unspecified