Healthcare Provider Details

I. General information

NPI: 1700790169
Provider Name (Legal Business Name): DILLAWAY WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

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

300 MAIN ST
MADISON NJ
07940-2369
US

IV. Provider business mailing address

300 MAIN ST STE 21
MADISON NJ
07940-2369
US

V. Phone/Fax

Practice location:
  • Phone: 201-228-3327
  • Fax:
Mailing address:
  • Phone: 201-228-3327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: CAITLIN DILLAWAY
Title or Position: OWNER
Credential: LCSW
Phone: 201-228-3327