Individual provider Active NPI

Rose Margaret Maire, LCADC, CCS, MAC

  • Addiction (Substance Use Disorder) Counselor
  • Montclair, NJ
National Provider Identifier
1255900460
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
37LC00036500 Issued in NJ
Practice address
104 Bloomfield Ave
Montclair, NJ 07042-4723
Phone
(973) 783-6655
Fax
(973) 223-1396
NPI assigned
Jun 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 37LC00036500 NJ Primary

Addresses

Primary practice location

104 Bloomfield Ave
Montclair, NJ 07042-4723

Mailing address

104 Bloomfield Ave
Montclair, NJ 07042-4723
Phone (973) 783-6655

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
37LC00036500NJMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1255900460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 BLOOMFIELD AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424723",
            "telephone_number": "973-783-6655",
            "fax_number": "973-223-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 BLOOMFIELD AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424723",
            "telephone_number": "973-783-6655",
            "fax_number": "973-223-1396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIRE",
        "first_name": "ROSE",
        "middle_name": "MARGARET",
        "credential": "LCADC, CCS, MAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00036500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.