Kimberly Mackanic
Clinical Social Worker
1075 Easton Ave Ste 11/319
Somerset
, New Jersey 08873-1648
Kimberly Mackanic
Clinical Social Worker
1075 Easton Ave Ste 11/319
Somerset
, New Jersey 08873-1648
(732) 630-5968
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About
Features
Specialties
- Clinical Social Worker
Languages spoken
- English
Location
First Address
- Kimberly Mackanic
- 1075 Easton Ave Ste 11319
- Somerset, NJ
- Zip : 08873-1648
- Phone : (732) 630-5968
Second Address
- Kimberly Mackanic
- 1075 Easton Ave Ste 11/319
- Somerset, NJ
- Zip : 08873-1648
- Phone : (732) 630-5968
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1041C0700X | Clinical Social Worker | 44SC05601700 | NJ |
National Provider Identifier
| NPI | 1003267337 |
|---|---|
| Provider Name | Kimberly Mackanic |
| First Address | Somerset, NJ 08873-1648 |
| Second Address | Somerset, NJ 08873-1648 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/06/2016 |
| Last Update Date | 01/04/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.