Maple Therapy Center LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC04898500 Issued in NJ

Legal business name

MAPLE THERAPY CENTER LLC

Practice address

65 N Maple Ave # 209
Ridgewood, NJ 07450-3233

Phone

(201) 566-1535

NPI assigned

Nov 11, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Susan O Peterson, L.C.S.W.

Title

Licensed Clinical Social Worker

Phone

(201) 566-1535

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1257897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257897600000",
    "number": "1225365372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 N MAPLE AVE # 209",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503233",
            "telephone_number": "201-566-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 N MAPLE AVE # 209",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503233",
            "telephone_number": "201-566-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-11",
        "last_updated": "2009-11-11",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "201-566-1535",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "L.C.S.W."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04898500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank P Manginello, M.D.
• Cristina M. Maniu, M.D.
• Juliana Wernikowski Mansfield, ATR - BC, LPC
• Maple Eye Care Associates PA
• Maple Eyecare, LLC
• Marilen T Marcelo
• Marek Belz LLC
• Catherine M Maresca Berezansky, LCSW
• Margaret C. Fraser MD
• Sharon V Marigliani, PHD

• Clinical Social Worker in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2009; 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.