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General NPI Number Information
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NPI Number | 1528547783
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Entity Type | Individual
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Provider Name | JAIMIE HELEN MIRAGLIA LCSW, LCADC
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Gender | Female
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Dates
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Enumeration Date | 08/08/2018
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Last Update Date | 12/29/2024
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Provider Practice Location Address
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Address Line | 317 GEORGE ST
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-2008
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Country | US
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Telephone | 732-640-8128
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Fax |
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Provider Business Mailing Address
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Address Line | 4 NARICON PL
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-1121
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Country | US
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Telephone | 908-616-1503
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Fax |
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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 | 37LC00325500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL06397800
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License Number State | NJ
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