Individual
MRS. COLLEEN DIVENY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
509 MAIN ST BLDG C, TOMS RIVER, NJ 08753-7402
(732) 674-9913
Mailing address
509 MAIN ST BLDG C, TOMS RIVER, NJ 08753-7402
(732) 674-9913
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
44SC056855800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0029807
—
NJ
Enumeration date
11/05/2018
Last updated
03/30/2022
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