Provider Demographics
NPI:1326803172
Name:CONSULMAGNO, DOREEN (LPC, LCADC, ACS)
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:
Last Name:CONSULMAGNO
Suffix:
Gender:F
Credentials:LPC, LCADC, ACS
Other - Prefix:
Other - First Name:DOREEN
Other - Middle Name:
Other - Last Name:COSENZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31 TOAD LN
Mailing Address - Street 2:
Mailing Address - City:RINGOES
Mailing Address - State:NJ
Mailing Address - Zip Code:08551-1022
Mailing Address - Country:US
Mailing Address - Phone:908-239-5775
Mailing Address - Fax:
Practice Address - Street 1:31 TOAD LN
Practice Address - Street 2:
Practice Address - City:RINGOES
Practice Address - State:NJ
Practice Address - Zip Code:08551-1022
Practice Address - Country:US
Practice Address - Phone:908-239-5775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00075400101YA0400X
NJ37PC00016100101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)