Healthcare Provider Details

I. General information

NPI: 1518367549
Provider Name (Legal Business Name): VALERIE MCMILLEN LCSW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2014
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1806 ROUTE 35 STE 303F
OAKHURST NJ
07755-2764
US

IV. Provider business mailing address

1806 ROUTE 35 STE 303F
OAKHURST NJ
07755-2764
US

V. Phone/Fax

Practice location:
  • Phone: 732-754-1359
  • Fax:
Mailing address:
  • Phone: 732-754-1359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05390600
License Number StateNJ

VIII. Authorized Official

Name: VALERIE MCMILLEN
Title or Position: OWNER
Credential: LCSW
Phone: 732-754-1359