Doctor Name: | MR. THOMAS B MAGNUS |
NPI Number: | 1144563131 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 37PC00441900 |
Business Practice Address: | 623 River Rd Suite 2g Fair Haven, NJ - 077043200 |
Business Phone Number: | 7325398911 |
Business Fax Number: | 8883936367 |
Mailing Address: | 623 River Rd, Suite 2g FAIR HAVEN |
State: | NJ |
Postal Code: | 077043200 |
Phone Number: | 7325398911 |
Fax Number: | |
NPI Enumeration Date: | 03/28/2013 |
NPI Last Update Date: | 05/18/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 37PC00441900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |