Healthcare Provider Details

I. General information

NPI: 1770497216
Provider Name (Legal Business Name): MARY CATHERINE HEALY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 BLOOMFIELD AVE STE 102
CALDWELL NJ
07006-5167
US

IV. Provider business mailing address

13 CHERRY LN
CALDWELL NJ
07006-5704
US

V. Phone/Fax

Practice location:
  • Phone: 973-898-5892
  • Fax:
Mailing address:
  • Phone: 862-485-2928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number37AC00978400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: