Provider Demographics
NPI:1902679129
Name:PATRONICK, KATELYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:KATELYNN
Middle Name:
Last Name:PATRONICK
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 1:159 CAMERON DR
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-1662
Mailing Address - Country:US
Mailing Address - Phone:732-343-1599
Mailing Address - Fax:
Practice Address - Street 1:490 SCHOOLEYS MOUNTAIN RD STE 12
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-4002
Practice Address - Country:US
Practice Address - Phone:973-691-3030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC062809001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty