Healthcare Provider Details

I. General information

NPI: 1720558844
Provider Name (Legal Business Name): MARIA T MAGANA LPC AND LMHC-D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2018
Last Update Date: 07/19/2026
Certification Date: 07/19/2026
Deactivation Date: 08/25/2022
Reactivation Date: 09/12/2022

III. Provider practice location address

310 AVENUE A FL 1
BAYONNE NJ
07002-1363
US

IV. Provider business mailing address

310 AVENUE A FL 1
BAYONNE NJ
07002-1363
US

V. Phone/Fax

Practice location:
  • Phone: 786-925-8159
  • Fax:
Mailing address:
  • Phone: 786-925-8159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC00655100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number015826
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: