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NPI 1851651178

NPI 1851651178 : JAMES JOSEPH SCANLON LSW, LCADC : VINELAND, NJ

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General NPI Number Information
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    NPI Number           |    1851651178
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    Entity Type          |    Individual 
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    Provider Name        |    JAMES JOSEPH SCANLON LSW, LCADC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/21/2012
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    Last Update Date     |    05/21/2012
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Provider Practice Location Address
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    Address Line         |    1038 EAST CHESTNUT AVE SUITE 210
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    City                 |    VINELAND
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    State                |    NJ
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    Zip                  |    08360
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    Country              |    US
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    Telephone            |    856-507-2730
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    Fax                  |    856-507-2737
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Provider Business Mailing Address
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    Address Line         |    1038 EAST CHESTNUT AVE SUITE 210
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    City                 |    VINELAND
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    State                |    NJ
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    Zip                  |    08360
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    Country              |    US
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    Telephone            |    856-507-2730
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    Fax                  |    856-507-2737
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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       |    37LC00109400
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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       |    44SL05112000
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    License Number State |    NJ
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