Individual
KELVIN LYNN BEATTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCADC
Contact information
Practice address
777 BLOOMFIELD AVE, CLIFTON, NJ 07012-1242
(973) 594-0125
Mailing address
291 PROSPECT AVE, WEST ORANGE, NJ 07052-4205
(973) 336-7323
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00328300
NJ
Other
Enumeration date
07/05/2021
Last updated
07/05/2021
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