Provider Demographics
NPI:1821810227
Name:GOLEBIEWSKI, MAYA (LSW)
Entity type:Individual
Prefix:
First Name:MAYA
Middle Name:
Last Name:GOLEBIEWSKI
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 HAYWARD PL
Mailing Address - Street 2:
Mailing Address - City:WALLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07057-1117
Mailing Address - Country:US
Mailing Address - Phone:973-930-4867
Mailing Address - Fax:
Practice Address - Street 1:330 MILLTOWN RD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-2267
Practice Address - Country:US
Practice Address - Phone:848-205-1799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL07176900104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker