Provider Demographics
NPI:1629700265
Name:CELENTANO, KATHERYN A (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHERYN
Middle Name:A
Last Name:CELENTANO
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 1:75 WASHINGTON VALLEY ROAD
Mailing Address - Street 2:CN753, BOX 123
Mailing Address - City:BEDMINSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07921
Mailing Address - Country:US
Mailing Address - Phone:908-248-2765
Mailing Address - Fax:
Practice Address - Street 1:20 ENCAMPMENT DR
Practice Address - Street 2:
Practice Address - City:BEDMINSTER
Practice Address - State:NJ
Practice Address - Zip Code:07921-1835
Practice Address - Country:US
Practice Address - Phone:908-248-2765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC058994001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical