Provider Demographics
NPI:1427679802
Name:HERNANDEZ-KEARNS, IRENE (LPC)
Entity type:Individual
Prefix:MRS
First Name:IRENE
Middle Name:
Last Name:HERNANDEZ-KEARNS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE HIAWATHA
Mailing Address - State:NJ
Mailing Address - Zip Code:07034-2134
Mailing Address - Country:US
Mailing Address - Phone:201-723-8453
Mailing Address - Fax:
Practice Address - Street 1:35 MADISON AVE
Practice Address - Street 2:
Practice Address - City:LAKE HIAWATHA
Practice Address - State:NJ
Practice Address - Zip Code:07034-2134
Practice Address - Country:US
Practice Address - Phone:201-723-8453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00507000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty