Organization Active NPI

Mediation and Therapy Associates LLC

  • Clinical Social Worker
  • Red Bank, NJ
National Provider Identifier
1336373687
Registry record updated Jun 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC00193500 Issued in NJ
Legal business name
MEDIATION AND THERAPY ASSOCIATES LLC
Practice address
104 110 Maple Ave
Red Bank, NJ 07701-6356
Phone
(732) 530-2951
NPI assigned
May 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2009

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

Authorized official

Name
Mary M Muise, LCSW
Title
Owner
Phone
(732) 530-2951

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 44SC00193500 NJ Primary

Addresses

Primary practice location

104 110 Maple Ave
Red Bank, NJ 07701-6356

Mailing address

104 110 Maple Ave
Red Bank, NJ 07701-6356
Phone (732) 530-2951

National Provider Directory

National Provider Directory

Locations

104 Maple Ave
Red Bank, NJ 07701
Phone (732) 245-7941

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1242259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245196800000",
    "number": "1336373687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 110 MAPLE AVE",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077016356",
            "telephone_number": "732-530-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 110 MAPLE AVE",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077016356",
            "telephone_number": "732-530-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIATION AND THERAPY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-14",
        "last_updated": "2009-06-17",
        "status": "A",
        "authorized_official_last_name": "MUISE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-530-2951",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00193500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.