MEDICARE: MS. LINDSAY KOKINEN M.S.W., L.C.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	44SC04771900	NJ

General Provider Information

NPI Number	:	1447415997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDSAY KOKINEN M.S.W., L.C.S.W.

Provider Business Mailing Address
First Line	:	150 MALLINSON ST
Second Line	:
City	:	ALLENDALE
State	:	NJ
Zip	:	07401-1918
Country	:	US
Telephone Number	:	201-563-3051
Fax Number	:

Provider Business Practice Location Address
First Line	:	37 E ALLENDALE AVE
Second Line	:
City	:	ALLENDALE
State	:	NJ
Zip	:	07401-2095
Country	:	US
Telephone Number	:	201-327-2424
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2008
Last Update Date	:	07/24/2008

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