Healthcare Provider Details

I. General information

NPI: 1770908584
Provider Name (Legal Business Name): KIM FINNIE LCSW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2014
Last Update Date: 03/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 W MERCHANT ST
AUDUBON NJ
08106-1424
US

IV. Provider business mailing address

108 W MERCHANT ST
AUDUBON NJ
08106-1424
US

V. Phone/Fax

Practice location:
  • Phone: 856-278-0099
  • Fax: 856-546-1480
Mailing address:
  • Phone: 856-278-0099
  • Fax: 856-546-1480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05401900
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. KIM FINNIE
Title or Position: OWNER
Credential: LCSW
Phone: 856-278-0099