=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679493191
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MAGGIE VLAZNY LCSW, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/16/2026
-----------------------------------------------------
Last Update Date | 07/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 208 CARMITA AVE
-----------------------------------------------------
City | RUTHERFORD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07070-1632
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-236-0020
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 208 CARMITA AVE
-----------------------------------------------------
City | RUTHERFORD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07070-1632
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-236-0020
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MARGARET VLAZNY
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 973-236-0020
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------