Provider Demographics
NPI:1598795924
Name:HEALEY, CAROL (MS APRN, BC)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:HEALEY
Suffix:
Gender:F
Credentials:MS APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 SOUTH EUCLID AVENUE
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-2503
Mailing Address - Country:US
Mailing Address - Phone:908-654-0903
Mailing Address - Fax:908-654-0903
Practice Address - Street 1:114 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-2130
Practice Address - Country:US
Practice Address - Phone:908-654-0903
Practice Address - Fax:908-654-0903
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC04834900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
645882Medicare ID - Type Unspecified