Individual provider Active NPI

Marilyn McCusker, LCADC

  • Addiction (Substance Use Disorder) Counselor
  • Bridgewater, NJ
National Provider Identifier
1083892145
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
37LC00024500 Issued in NJ
Practice address
540 Route 22
Bridgewater, NJ 08807-2405
Phone
(908) 722-1881
NPI assigned
Jan 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SW01090300 NJ
Addiction (Substance Use Disorder) Counselor 101YA0400X 37LC00024500 NJ Primary

Addresses

Primary practice location

540 Route 22
Bridgewater, NJ 08807-2405

Mailing address

319 Maple St
Attn Avazquez
Perth Amboy, NJ 08861-4101
Phone (732) 324-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
37LC00024500NJMDAddiction (Substance Use Disorder) Counselor
44SW01090300NJMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1083892145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 MAPLE ST",
            "address_2": "ATTN AVAZQUEZ",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088614101",
            "telephone_number": "732-324-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 ROUTE 22",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072405",
            "telephone_number": "908-722-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCUSKER",
        "first_name": "MARILYN",
        "credential": "LCADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-31",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SW01090300",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00024500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.