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Provider Information for 1649402587


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Mrs. DORIS ANGEL MCRAE MFT,LPC,LRC


Sex: Female

NPI: 1649402587
Last Updated: 2009-08-11
Certification Date:

Details

NameValue
NPI1649402587
Enumeration Date2009-08-11
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 200 CAMPBELL DR STE 205
WILLINGBORO, NJ 08046-1068
United States

Phone: 609-505-2927 | Fax:856-385-7178
 
Primary Practice Address 200 CAMPBELL DR STE 205
WILLINGBORO, NJ 08046-1068
United States

Phone: 609-505-2927 | Fax:856-385-7178
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YA0400X - Counselor - Addiction (Substance Use Disorder)NJ37RC00243400
No 101YM0800X - Counselor - Mental HealthNJ37RC00243400
Yes 101YP2500X - Counselor - ProfessionalNJ37PC00233500
No 101YS0200X - Counselor - SchoolNJ00170349
No 106H00000X - Marriage & Family Therapist NJ37PC00233500