Healthcare Provider Details

I. General information

NPI: 1629257605
Provider Name (Legal Business Name): ADAM J KIERNAN MA, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2007
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W SYLVANIA AVE STE 5
NEPTUNE CITY NJ
07753-6269
US

IV. Provider business mailing address

201 W SYLVANIA AVE STE 5
NEPTUNE CITY NJ
07753-6269
US

V. Phone/Fax

Practice location:
  • Phone: 908-902-1543
  • Fax:
Mailing address:
  • Phone: 908-902-1543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: