Provider Demographics
NPI:1700107026
Name:LOWENFELS, KATHLEEN A (LCSW, BCBA)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:A
Last Name:LOWENFELS
Suffix:
Gender:F
Credentials:LCSW, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 VANDERBERG PL
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009-1039
Mailing Address - Country:US
Mailing Address - Phone:551-574-0988
Mailing Address - Fax:
Practice Address - Street 1:28 MILLBURN AVE
Practice Address - Street 2:SUITE #7
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1039
Practice Address - Country:US
Practice Address - Phone:551-574-0988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-21
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054775001041C0700X
NJ1-12-12000103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst