Organization
KEYSTONE PSYCHOLOGICAL GROUP, LLC
Active
Other names
Keystone Psyhcological Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTINE MACMILLAN M.D. (MEDICAL DIRECTOR)
(917) 549-0215
Entity
Organization
Contact information
Practice address
315 E NORTHFIELD RD, SUITE 3A, LIVINGSTON, NJ 07039-4896
(917) 549-0215
Mailing address
1861 LAKE AVE, SCOTCH PLAINS, NJ 07076-2919
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
37PC00038100
NJ
1041C0700X
Clinical Social Worker
44SC00138300
NJ
106H00000X
Marriage & Family Therapist
37FI00160600
NJ
2084P0800X
Psychiatry Physician
Primary
25MA07642800
NJ
Other
Enumeration date
07/17/2013
Last updated
07/17/2013
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