Provider Demographics
NPI:1841630837
Name:MADELINE PASKE BAULIG, LCSW, LLC
Entity type:Organization
Organization Name:MADELINE PASKE BAULIG, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:MADELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PASKE BAULIG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:973-953-4429
Mailing Address - Street 1:13 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940-1400
Mailing Address - Country:US
Mailing Address - Phone:973-953-4429
Mailing Address - Fax:
Practice Address - Street 1:13 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-1400
Practice Address - Country:US
Practice Address - Phone:973-953-4429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-05
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC47865251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health