Provider Demographics
NPI:1356402606
Name:DUNKEL, MILLICENT (LCSW, PHD)
Entity type:Individual
Prefix:DR
First Name:MILLICENT
Middle Name:
Last Name:DUNKEL
Suffix:
Gender:F
Credentials:LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 KIEL AVE
Mailing Address - Street 2:
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-2572
Mailing Address - Country:US
Mailing Address - Phone:973-838-8888
Mailing Address - Fax:201-891-9254
Practice Address - Street 1:2 KIEL AVE
Practice Address - Street 2:
Practice Address - City:KINNELON
Practice Address - State:NJ
Practice Address - Zip Code:07405-2572
Practice Address - Country:US
Practice Address - Phone:973-838-8888
Practice Address - Fax:201-891-9254
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC00037101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ051472OtherVALUE OPTIONS
NJ1041722OtherMHN SERVICES
NJ2585151OtherOXFORD HEALTH
NJ640782Medicare ID - Type UnspecifiedPSYCHOLOGICAL SERVICES