Organization
KWENYAN PROFESSIONAL HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL CASSELL MA, MPH, LPC, LCADC (EXECUTIVE DIRECTOR/PRESIDENT)
(973) 672-6900
Entity
Organization
Contact information
Practice address
60 EVERGREEN PL, SUITE 500, EAST ORANGE, NJ 07018-2106
(973) 672-6900
(866) 376-8262
Mailing address
60 EVERGREEN PL, SUITE 500, EAST ORANGE, NJ 07018-2106
(973) 672-6900
(866) 376-8262
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00330900
NJ
103TA0400X
Addiction (Substance Use Disorder) Psychologist
37LC00040000
NJ
251S00000X
Community/Behavioral Health Agency
LPC004779
PA
374U00000X
Home Health Aide
26NR13660400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0175366
—
NJ
Enumeration date
10/28/2008
Last updated
06/02/2011
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