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General NPI Number Information
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NPI Number | 1447412671
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Entity Type | Individual
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Provider Name | SHANTE JAMES LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 10/28/2010
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Provider Practice Location Address
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Address Line | 617 UNION AVE BLDG 3, SUITE 20
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City | BRIELLE
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State | NJ
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Zip | 08730-1838
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Country | US
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Telephone | 732-814-0764
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Fax | 732-626-8886
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Provider Business Mailing Address
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Address Line | PO BOX 1383
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City | JACKSON
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State | NJ
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Zip | 08527-0383
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Country | US
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Telephone | 732-814-0764
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Fax | 732-626-8889
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05331800
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License Number State | NJ
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