Healthcare Provider Details

I. General information

NPI: 1679405369
Provider Name (Legal Business Name): CHLOE D. MCMILLAN CMHCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 BRICK BLVD BLDG 2
BRICK NJ
08723-7984
US

IV. Provider business mailing address

145 PINEHURST RD
BRICK NJ
08723-5452
US

V. Phone/Fax

Practice location:
  • Phone: 732-832-3444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC00961200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number37AC00961200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: