Provider Demographics
NPI:1902974629
Name:CHAPMAN, MARILYN JAMES (RN LCADC LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:JAMES
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:RN LCADC LCSW
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Mailing Address - Street 1:21 EVANS PLACE
Mailing Address - Street 2:CO NEW BRIDGE SERVICES INC
Mailing Address - City:POMTON PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07444
Mailing Address - Country:US
Mailing Address - Phone:973-907-2700
Mailing Address - Fax:973-839-4770
Practice Address - Street 1:390 MAIN RD
Practice Address - Street 2:
Practice Address - City:MONTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07045
Practice Address - Country:US
Practice Address - Phone:973-316-9333
Practice Address - Fax:973-316-5790
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ37LC00019400101YA0400X
NJ44SC043894001041C0700X
NJ26NR02868500163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ000721Medicare ID - Type Unspecified