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General NPI Number Information
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NPI Number | 1821357997
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Entity Type | Organization
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Legal Business Name | PATRICIA KENNEY COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 05/10/2012
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Last Update Date | 05/10/2012
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Provider Practice Location Address
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Address Line | 717 E ELMER ST SUITE 6
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City | VINELAND
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State | NJ
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Zip | 08360-4758
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Country | US
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Telephone | 856-691-2424
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Fax | 856-691-2433
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Provider Business Mailing Address
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Address Line | 717 E ELMER ST SUITE 6
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City | VINELAND
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State | NJ
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Zip | 08360-4758
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Country | US
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Telephone | 856-691-2424
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Fax | 856-691-2433
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | MS. PATRICIA LEE KENNEY
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Credential | LCSW, MAC
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Telephone | 856-691-2424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC04764600
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License Number State | NJ
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