Provider Demographics
NPI:1932431004
Name:KIRCHER, TIMOTHY G (LCSW)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:G
Last Name:KIRCHER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:TIM
Other - Middle Name:
Other - Last Name:KIRCHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:179 AVENUE AT THE CMN
Mailing Address - Street 2:SUITE #102
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4804
Mailing Address - Country:US
Mailing Address - Phone:732-586-3300
Mailing Address - Fax:732-544-8099
Practice Address - Street 1:179 AVENUE AT THE CMN
Practice Address - Street 2:SUITE #102
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4804
Practice Address - Country:US
Practice Address - Phone:732-586-3300
Practice Address - Fax:732-544-8099
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-01
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054141001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical