MEDICARE: PATRICIA DOOLEY LPC

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	101YP2500X	Professional Counselor	37PC00029100	NJ

General Provider Information

NPI Number	:	1689752990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA DOOLEY LPC

Provider Business Mailing Address
First Line	:	786 MOUNTAIN BLVD
Second Line	:	SUITE 104
City	:	WATCHUNG
State	:	NJ
Zip	:	07069-6268
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	786 MOUNTAIN BLVD
Second Line	:	SUITE 104
City	:	WATCHUNG
State	:	NJ
Zip	:	07069-6268
Country	:	US
Telephone Number	:	908-322-9623
Fax Number	:

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

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	05/12/2014

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