Provider Demographics
NPI:1083025274
Name:KINLEY, BETH DELAINE (CSW 44SW00740300)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:DELAINE
Last Name:KINLEY
Suffix:
Gender:F
Credentials:CSW 44SW00740300
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1644 RENSSELAER RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-6349
Mailing Address - Country:US
Mailing Address - Phone:201-315-6700
Mailing Address - Fax:
Practice Address - Street 1:1644 RENSSELAER RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-6349
Practice Address - Country:US
Practice Address - Phone:201-315-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-10
Last Update Date:2014-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SW00740300104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker