Provider Demographics
NPI:1689294225
Name:REDFEARN, MARCEL (LCSW, LCADC)
Entity Type:Individual
Prefix:
First Name:MARCEL
Middle Name:
Last Name:REDFEARN
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 STEDWICK DR
Mailing Address - Street 2:
Mailing Address - City:BUDD LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07828-3739
Mailing Address - Country:US
Mailing Address - Phone:862-258-5112
Mailing Address - Fax:
Practice Address - Street 1:181 NEW RD STE 304
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-5625
Practice Address - Country:US
Practice Address - Phone:862-258-5112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC058934001041C0700X
NJ37LC00274800101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)