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Individual
KIMBERLY MACKANIC
Active
Individual
KIMBERLY MACKANIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LCADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00293000
NJ
1041C0700X
Clinical Social Worker
Primary
44SC05601700
NJ
Other
Enumeration date
06/28/2016
Last updated
06/12/2026
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