Healthcare Provider Details

I. General information

NPI: 1457179996
Provider Name (Legal Business Name): KATHERINE CECELIA HEMMINGS M.ED., LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2024
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date: 04/08/2025
Reactivation Date: 07/27/2026

III. Provider practice location address

1022 HAMBURG TURNPIKE
KLAYNE NJ
07470
US

IV. Provider business mailing address

1022 HAMBURG TURNPIKE
KLAYNE NJ
07470
US

V. Phone/Fax

Practice location:
  • Phone: 201-952-1096
  • Fax:
Mailing address:
  • Phone: 201-952-1096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC00816400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: