Doctor Name: | HEIDI O'DONNELL |
NPI Number: | 1063760619 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW LCSW |
License Number: | 44SC05576400 |
Business Practice Address: | 355 Route 46 W Mountain Lakes, NJ - 070461744 |
Business Phone Number: | 2018742220 |
Business Fax Number: | |
Mailing Address: | 355 Route 46 W, MOUNTAIN LAKES |
State: | NJ |
Postal Code: | 070461744 |
Phone Number: | 2018742220 |
Fax Number: | |
NPI Enumeration Date: | 08/29/2012 |
NPI Last Update Date: | 03/31/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 44SC05576400 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |