Provider Demographics
NPI:1962130989
Name:VAZQUEZ, MAGDALENA (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:
Last Name:VAZQUEZ
Suffix:
Gender:
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:07416-1717
Mailing Address - Country:US
Mailing Address - Phone:973-462-9641
Mailing Address - Fax:
Practice Address - Street 1:27 TAYLOR RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NJ
Practice Address - Zip Code:07416-1717
Practice Address - Country:US
Practice Address - Phone:973-462-9641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-09
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC01116100101YP2500X
NJ2022-000181101YA0400X
NJ37AC00648900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)