Individual
JOHN CONNEELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCADC
Contact information
Practice address
PREFERRED BEHAVIORAL HEALTH OF NJ, 700 AIRPORT ROAD, LAKEWOOD, NJ 08701
(732) 367-4700
(732) 364-2253
Mailing address
1519 VALLEY DR, WALL TOWNSHIP, NJ 07719-3929
(732) 996-4889
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00030300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0029807
—
NJ
Enumeration date
02/01/2007
Last updated
07/09/2007
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