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General NPI Number Information
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NPI Number | 1952443368
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Entity Type | Individual
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Provider Name | KATHLEEN HALCZLI M.A., L.P.C.
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Gender | Female
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 88 PARK ST
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City | MONTCLAIR
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State | NJ
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Zip | 07042-5915
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Country | US
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Telephone | 201-440-4260
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Fax |
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Provider Business Mailing Address
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Address Line | 464 LIBERTY ST APT 310C
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City | LITTLE FERRY
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State | NJ
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Zip | 07643-1079
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Country | US
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Telephone | 201-440-4260
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 37PC00133200
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License Number State | NJ
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