Provider Demographics
NPI:1922262062
Name:MCMILLEN, VALERIE (LCSW)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:MCMILLEN
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 1:6 MAGNOLIA DR
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1135
Mailing Address - Country:US
Mailing Address - Phone:732-754-1359
Mailing Address - Fax:732-987-9769
Practice Address - Street 1:2358 ROUTE 9
Practice Address - Street 2:CHERRY TREE PLAZA
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-4017
Practice Address - Country:US
Practice Address - Phone:732-754-1359
Practice Address - Fax:732-987-9769
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-17
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053906001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ176823C4BOtherMEDICARE
NJCP0012065Medicaid