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Individual

COLLEEN MCKENNA

Active
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Individual

COLLEEN MCKENNA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSW

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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