Provider Demographics
NPI:1164930632
Name:KINCADE, DEBRA NEWELL (LPC)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:NEWELL
Last Name:KINCADE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-4865
Mailing Address - Country:US
Mailing Address - Phone:848-248-9275
Mailing Address - Fax:
Practice Address - Street 1:45 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-4865
Practice Address - Country:US
Practice Address - Phone:848-248-9275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-17
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00427100101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health