Healthcare Provider Details

I. General information

NPI: 1609401579
Provider Name (Legal Business Name): MARY BETH MCCABE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2020
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CHURCH ST
PILESGROVE NJ
08098-2921
US

IV. Provider business mailing address

2 CHURCH ST
PILESGROVE NJ
08098-2921
US

V. Phone/Fax

Practice location:
  • Phone: 856-490-0133
  • Fax: 856-361-2720
Mailing address:
  • Phone: 609-202-5199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37PC00650000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: