Provider Demographics
NPI:1376701284
Name:KELLNER, MILLICENT H (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:MILLICENT
Middle Name:H
Last Name:KELLNER
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 ADAMS CT
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-2719
Mailing Address - Country:US
Mailing Address - Phone:609-443-5221
Mailing Address - Fax:
Practice Address - Street 1:3 ADAMS CT
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-2719
Practice Address - Country:US
Practice Address - Phone:609-443-5221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC002966001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical