Provider Demographics
NPI:1699832196
Name:HEALY, PATRICIA A (MA, LPC, LCADC, MAC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:A
Last Name:HEALY
Suffix:
Gender:F
Credentials:MA, LPC, LCADC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 HOOPER AVE SUITE 1
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753
Mailing Address - Country:US
Mailing Address - Phone:732-797-0400
Mailing Address - Fax:732-341-4185
Practice Address - Street 1:1310 HOOPER AVE SUITE 1
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753
Practice Address - Country:US
Practice Address - Phone:732-797-0400
Practice Address - Fax:732-341-4185
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJLPC02349101YM0800X
NJ37LC00013200101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health