Provider Demographics
NPI:1871097972
Name:JOSEPH MCGEADY LCSW , LLC
Entity type:Organization
Organization Name:JOSEPH MCGEADY LCSW , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGEADY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:609-651-5726
Mailing Address - Street 1:213 CARNEGIE CTR # 3052
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-9990
Mailing Address - Country:US
Mailing Address - Phone:609-651-5726
Mailing Address - Fax:
Practice Address - Street 1:9 GORDON AVE
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-1004
Practice Address - Country:US
Practice Address - Phone:609-651-5726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-22
Last Update Date:2018-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057525001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ44SC05752500OtherLCSW LICENSE