Healthcare Provider Details

I. General information

NPI: 1033231550
Provider Name (Legal Business Name): ANTHONY HUGHES KEARNEY LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 BELLEVILLE AVE SUITE 22
BLOOMFIELD NJ
07003-3652
US

IV. Provider business mailing address

95 SUNSET AVE
GLEN RIDGE NJ
07028-1816
US

V. Phone/Fax

Practice location:
  • Phone: 973-566-0890
  • Fax: 973-566-0896
Mailing address:
  • Phone: 973-744-1494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC00672500
License Number StateNJ

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: