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General NPI Number Information
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NPI Number | 1770474405
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Entity Type | Individual
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Provider Name | KALENE DEHAUT LCSW, MSW
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Gender | Female
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Dates
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Enumeration Date | 07/11/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 13 PROSPECT AVE
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City | RED BANK
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State | NJ
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Zip | 07701-2305
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Country | US
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Telephone | 646-760-8421
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Fax |
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Provider Business Mailing Address
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Address Line | 111 TOWN SQUARE PL STE 1238
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City | JERSEY CITY
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State | NJ
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Zip | 07310-1810
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Country | US
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Telephone | 646-760-8421
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 17065
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 086834
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC06515900
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License Number State | NJ
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