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Organization
VIRGINIA CONNELLY, LCSW, LLC
Active
Organization
VIRGINIA CONNELLY, LCSW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA MICKOLAJCZYK LCSW (OWNER)
(201) 300-6425
Entity
Organization
Contact information
Practice address
89 W RIDGEWOOD AVE, RIDGEWOOD, NJ 07450-3142
(201) 300-6425
Mailing address
0014 WHITEHALL ST, FAIR LAWN, NJ 07410-2913
(201) 300-6425
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC00575100
NJ
Other
Enumeration date
04/21/2010
Last updated
04/21/2010
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