MARY REILLY LPC
NPI 1053776963
Counselor - Professional in Rutherford, NJ
- Individual
- Female
- Counselor
- Professional
About MARY REILLY
This page provides the complete NPI Profile along with additional information for Mary Reilly, a provider established in Rutherford, New Jersey with a medical specialization in Counselor, focusing in professional . The healthcare provider is registered in the NPI registry with number 1053776963 assigned on December 2015. The practitioner's primary taxonomy code is 101YP2500X with license number 37PC003984000 (NJ). The provider is registered as an individual and her NPI record was last updated 10 years ago.
- NPI
- 1053776963 Verify this NPI
- Provider Name
- MARY REILLY LPC
- Other Name
- FOUNTAIN WORKS COUNSELING
- Other Name Type
- Professional Name (2)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 495 EDGEWOOD PL RUTHERFORD, NJ 07070
- Location Phone
- (908) 642-2383
- Mailing Address
- 495 EDGEWOOD PL RUTHERFORD, NJ 07070
- Mailing Phone
- (908) 642-2383
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 12-18-2015
- Last Update Date
- 02-02-2016
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor Professional
- Taxonomy Code
- 101YP2500X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 37PC003984000
- License State
- NJ
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1053776963, enumerated as an "individual" on December 18, 2015.
The provider is located at 495 EDGEWOOD PL RUTHERFORD, NJ 07070 and the phone number is (908) 642-2383.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
