Individual
CATHERINE ILLENYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1172 E RIDGEWOOD AVE STE 7, RIDGEWOOD, NJ 07450-3929
(732) 535-1426
Mailing address
240 MAIN ST APT 402, HACKENSACK, NJ 07601-5745
(732) 535-1426
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
44SC05816800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0023701
—
NJ
Enumeration date
09/02/2015
Last updated
01/01/2026
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