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NPI 1336450147

NPI 1336450147 : ERIN MAGEE-GARY LCADC : TOTOWA, NJ

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General NPI Number Information
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    NPI Number           |    1336450147
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    Entity Type          |    Individual 
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    Provider Name        |    ERIN MAGEE-GARY LCADC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/25/2010
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    Last Update Date     |    06/25/2010
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Provider Practice Location Address
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    Address Line         |    290 UNION BLVD STE 5 
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    City                 |    TOTOWA
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    State                |    NJ
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    Zip                  |    07512-2610
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    Country              |    US
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    Telephone            |    201-873-6361
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    405 RIVER PL 
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    City                 |    BUTLER
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    State                |    NJ
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    Zip                  |    07405-1087
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    Country              |    US
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    Telephone            |    201-873-6361
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    Fax                  |    973-241-4136
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    37LC00117200
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    License Number State |    NJ
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