Healthcare Provider Details

I. General information

NPI: 1811463284
Provider Name (Legal Business Name): MRS. SHANNON LEIGH MCLAUGHLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2018
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 DONNY BROOK DR
ALLENDALE NJ
07401-1422
US

IV. Provider business mailing address

227 DONNY BROOK DR
ALLENDALE NJ
07401-1422
US

V. Phone/Fax

Practice location:
  • Phone: 201-588-3491
  • Fax: 646-786-4040
Mailing address:
  • Phone: 201-588-3491
  • Fax: 646-786-4040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06583000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: