Provider Demographics
NPI:1699952267
Name:KAELIN, JANINE MARY (MA)
Entity type:Individual
Prefix:MS
First Name:JANINE
Middle Name:MARY
Last Name:KAELIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 FERNDALE RD
Mailing Address - Street 2:
Mailing Address - City:WEST MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07480-4110
Mailing Address - Country:US
Mailing Address - Phone:973-409-4933
Mailing Address - Fax:973-473-2308
Practice Address - Street 1:5 FERNDALE RD
Practice Address - Street 2:
Practice Address - City:WEST MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07480-4110
Practice Address - Country:US
Practice Address - Phone:973-409-4933
Practice Address - Fax:973-473-2308
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-26
Last Update Date:2008-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00296800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional