Shante James, LCSW

Individual provider Active NPI Clinical Social Worker · Brielle, NJ

NPI 1447412671 · NPPES record last updated Oct 28, 2010

Key facts

NPI
1447412671
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
44SC05331800 (NJ)
Practice address
617 Union Ave
BLDG 3, Suite 20
Brielle, NJ 08730-1838
Phone
(732) 814-0764
Fax
(732) 626-8886
NPI assigned
Jun 30, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
44SC05331800NJMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC05331800 NJ Yes

Addresses

Primary practice location

617 Union Ave
BLDG 3, Suite 20
Brielle, NJ 08730-1838

Mailing address

PO Box 1383
Jackson, NJ 08527-0383
Phone (732) 814-0764

Other providers in Brielle, NJ

All providers in Brielle, NJ · Clinical Social Worker in New Jersey

Sources for this page

Verify at the official NPI Registry.