Healthcare Provider Details

I. General information

NPI: 1942221361
Provider Name (Legal Business Name): BETH THOMAS-REA LCSW, LCADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BETH REA LCSW, LCADC

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 S FRANKLIN TPKE 3RD FLOOR
RAMSEY NJ
07446-2552
US

IV. Provider business mailing address

17 S FRANKLIN TPKE
RAMSEY NJ
07446-2552
US

V. Phone/Fax

Practice location:
  • Phone: 201-803-3576
  • Fax: 201-848-0061
Mailing address:
  • Phone: 201-753-1354
  • Fax: 201-848-0061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37LC00092400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05256800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: