Provider Demographics
NPI:1619282662
Name:KEHOE, MARIANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:KEHOE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 ALDEN ST
Mailing Address - Street 2:SUITE 16
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2149
Mailing Address - Country:US
Mailing Address - Phone:908-276-2254
Mailing Address - Fax:
Practice Address - Street 1:15 ALDEN ST
Practice Address - Street 2:SUITE 16
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2149
Practice Address - Country:US
Practice Address - Phone:908-276-2254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-15
Last Update Date:2010-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC001501001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical