Individual
MRS. SUSAN JOAN DONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
115 PINE STREET, RIDGEWOOD, NJ 07450
(201) 447-0364
(201) 445-2354
Mailing address
115 PINE ST, RIDGEWOOD, NJ 07450-1619
(201) 447-0364
(201) 445-2354
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SC00206800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44SC00206800
LCSW LICENSE
NJ
01
—
SWL4705997
MALPRACTICE INSURANCE
—
Enumeration date
08/21/2006
Last updated
03/20/2013
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