1023380888 NPI number — ELIZABETH JOANNA MCGUINNESS LCSW, LMSW, CSAT

Table of content: ELIZABETH JOANNA MCGUINNESS LCSW, LMSW, CSAT (NPI 1023380888)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023380888 NPI number — ELIZABETH JOANNA MCGUINNESS LCSW, LMSW, CSAT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCGUINNESS
Provider First Name:
ELIZABETH
Provider Middle Name:
JOANNA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW, LMSW, CSAT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHMIDT
Provider Other First Name:
ELIZABETH
Provider Other Middle Name:
JOANNA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1023380888
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
402 MAIN ST STE 100-265
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
METUCHEN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08840-1846
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-670-5664
Provider Business Mailing Address Fax Number:
848-260-3074

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
402 MAIN ST STE 202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
METUCHEN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08840-1893
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-670-5664
Provider Business Practice Location Address Fax Number:
848-260-3074
Provider Enumeration Date:
02/08/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  092172 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: 44SC05762400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)