Provider Demographics
NPI:1962674663
Name:AYRE, KIERAN R (LCSW, LCADC)
Entity type:Individual
Prefix:DR
First Name:KIERAN
Middle Name:R
Last Name:AYRE
Suffix:
Gender:M
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 MAPLE AVE STE 2R
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-5276
Mailing Address - Country:US
Mailing Address - Phone:973-670-3123
Mailing Address - Fax:973-210-9141
Practice Address - Street 1:58 MAPLE AVE STE 2R
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-5276
Practice Address - Country:US
Practice Address - Phone:973-670-3123
Practice Address - Fax:973-210-9141
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00017800101YA0400X
NJ44SC043327001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)