Individual
KYSHA UNDERWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Credential
LCADC
Contact information
Practice address
24 COLTS NECK DR, SICKLERVILLE, NJ 08081-5644
(856) 383-9359
Mailing address
24 COLTS NECK DR, SICKLERVILLE, NJ 08081-5644
(856) 383-9359
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00288500
NJ
Other
Enumeration date
04/09/2025
Last updated
04/09/2025
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