Provider Demographics
NPI:1083623458
Name:BOSSARDET-WEST, KERRI A (LCSW)
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:A
Last Name:BOSSARDET-WEST
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KERRI
Other - Middle Name:A
Other - Last Name:BOSSARDET
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LSW
Mailing Address - Street 1:25 LINDSLEY DRIVE
Mailing Address - Street 2:ATTN: C. LAMPRON - SUITE 100
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960
Mailing Address - Country:US
Mailing Address - Phone:973-451-0246
Mailing Address - Fax:973-451-0166
Practice Address - Street 1:95 MOUNT KEMBLE AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-5155
Practice Address - Country:US
Practice Address - Phone:888-247-1400
Practice Address - Fax:973-451-0166
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052264001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical