Kathleen Shaughnessy, | |
395 S Center St, Orange, NJ 07050-3205 | |
(862) 253-4422 | |
Not Available |
Full Name | Kathleen Shaughnessy |
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Gender | Female |
Speciality | Counselor - Mental Health |
Location | 395 S Center St, Orange, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1669002796 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 37AC00334300 (New Jersey) | Primary |
Entity Name | Theracorp, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1063947828 PECOS PAC ID: 8426319104 Enrollment ID: O20180220001235 |
Mailing Address | Practice Location Address |
---|---|
Kathleen Shaughnessy, 26 Beaumont Pl Apt 3h, Newark, NJ 07104-1657 Ph: (308) 884-5852 | Kathleen Shaughnessy, 395 S Center St, Orange, NJ 07050-3205 Ph: (862) 253-4422 |
Jane Alison Penola, LAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 395 S Center St, Orange, NJ 07050 Phone: 973-675-3817 | |
Ms. Dileiny Paulino, LAC Counselor Medicare: Medicare Enrolled Practice Location: 395 S Center St, Orange, NJ 07050 Phone: 973-675-3817 Fax: 973-673-5782 | |
Martine Lamour, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 493 Valley St Apt 21, Orange, NJ 07050 Phone: 609-992-0230 | |
Addys Santos, Counselor Medicare: Not Enrolled in Medicare Practice Location: 309 Elizabeth St, Orange, NJ 07050 Phone: 973-651-8388 | |
Ciera L Thornton, Counselor Medicare: Not Enrolled in Medicare Practice Location: 248 Reynolds Ter Apt 1p, Orange, NJ 07050 Phone: 973-619-2594 | |
Ijeoma Marcia Duru- Akabogu, Counselor Medicare: Not Enrolled in Medicare Practice Location: 150 Cleveland St Apt B8, Orange, NJ 07050 Phone: 862-704-2155 | |
Mrs. Tonia Robinson-lloyd, Counselor Medicare: Not Enrolled in Medicare Practice Location: 98e Hillyer St, Orange, NJ 07050 Phone: 862-253-3427 |