Healthcare Provider Details

I. General information

NPI: 1902974629
Provider Name (Legal Business Name): MARILYN JAMES CHAPMAN RN LCADC LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 MAIN RD
MONTVILLE NJ
07045
US

IV. Provider business mailing address

21 EVANS PLACE CO NEW BRIDGE SERVICES INC
POMTON PLAINS NJ
07444
US

V. Phone/Fax

Practice location:
  • Phone: 973-316-9333
  • Fax: 973-316-5790
Mailing address:
  • Phone: 973-907-2700
  • Fax: 973-839-4770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37LC00019400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC04389400
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR02868500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: