Provider Demographics
NPI:1336572106
Name:MCDERMOTT, EILEEN S (LCSW)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:S
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:EILEEN
Other - Middle Name:FRANCES
Other - Last Name:SHEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:629 N SCOTCH PLAINS AVE
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-4452
Mailing Address - Country:US
Mailing Address - Phone:908-209-0229
Mailing Address - Fax:
Practice Address - Street 1:629 N SCOTCH PLAINS AVE
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-4452
Practice Address - Country:US
Practice Address - Phone:908-209-0229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-15
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC049117001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical