Provider Demographics
NPI:1215571716
Name:KENNEY, JULWEL ANN (PHD, MS, CDC, CPCMP)
Entity Type:Individual
Prefix:DR
First Name:JULWEL
Middle Name:ANN
Last Name:KENNEY
Suffix:
Gender:F
Credentials:PHD, MS, CDC, CPCMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 E HUNTER AVE, STE 2
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07607-1830
Mailing Address - Country:US
Mailing Address - Phone:201-523-2260
Mailing Address - Fax:
Practice Address - Street 1:48 E HUNTER AVE STE 2A
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07607-1830
Practice Address - Country:US
Practice Address - Phone:201-523-2260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-29
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1215571716Medicaid