Provider Demographics
NPI:1376935338
Name:MULLARNEY, DOREEN (LPC)
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:
Last Name:MULLARNEY
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 1:721 AUTH AVE
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-2965
Mailing Address - Country:US
Mailing Address - Phone:609-468-5603
Mailing Address - Fax:
Practice Address - Street 1:721 AUTH AVE
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-2965
Practice Address - Country:US
Practice Address - Phone:609-468-5603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-28
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00616900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional