Individual
COLLEEN MCKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
3455 ROUTE 66, NEPTUNE, NJ 07753-2758
(732) 292-2929
(732) 782-0345
Mailing address
3455 ROUTE 66, NEPTUNE, NJ 07753-2758
(732) 292-2929
(732) 782-0345
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00218500
NJ
1041C0700X
Clinical Social Worker
Primary
44SC05590600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4542703
—
NJ
Enumeration date
07/07/2011
Last updated
03/17/2015
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