Provider Demographics
NPI:1861184814
Name:DAVID, MAYA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MAYA
Middle Name:
Last Name:DAVID
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469 DOGWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLINVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08322-3708
Mailing Address - Country:US
Mailing Address - Phone:856-979-5255
Mailing Address - Fax:
Practice Address - Street 1:469 DOGWOOD AVE
Practice Address - Street 2:
Practice Address - City:FRANKLINVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08322-3708
Practice Address - Country:US
Practice Address - Phone:856-979-5255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC061910001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical