Most Relevant Information
Provider Data
| NPI Number: | 1003267337 |
| Provider Name: | KIMBERLY MACKANIC LCSW, LCADC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 37LC00293000 |
Most Important Dates
| Enumeration Date: | 06/28/2016 |
| Last Updated: | 08/30/2024 |
Provider Practice Location
3036 ROUTE 35 # 321
HAZLET
NJ
077301505
Practice Location Phone/Fax
| Phone: | 7326305968 |
| Fax: |
Provider Mailing Location
3036 ROUTE 35 STE 321
HAZLET
NJ
077301505
Provider Mailing Phone/Fax
| Phone: | 7326305968 |
| Fax: |