Provider Demographics
NPI:1982234969
Name:MUSHINSKI, MARJORIE A (LCSW)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:A
Last Name:MUSHINSKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1134 SMITHVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-6720
Mailing Address - Country:US
Mailing Address - Phone:609-410-5170
Mailing Address - Fax:
Practice Address - Street 1:33 GRANT ST
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY
Practice Address - State:NJ
Practice Address - Zip Code:08060-1308
Practice Address - Country:US
Practice Address - Phone:609-410-5170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-18
Last Update Date:2020-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05846700101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor