Provider Demographics
NPI:1285943191
Name:MULLIN, VERONICA (LCSW, LCADC)
Entity type:Individual
Prefix:MS
First Name:VERONICA
Middle Name:
Last Name:MULLIN
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 DODD ST
Mailing Address - Street 2:
Mailing Address - City:LAURENCE HARBOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08879-2648
Mailing Address - Country:US
Mailing Address - Phone:848-468-0254
Mailing Address - Fax:732-242-9732
Practice Address - Street 1:141 HWY 34
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-2187
Practice Address - Country:US
Practice Address - Phone:848-468-0254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00142000101YA0400X
NJ44SCO54367001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)