Provider Demographics
NPI:1730870791
Name:MARGEOTES, KATHLEEN (LSW)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:MARGEOTES
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 ORANGE RD APT 14A
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2153
Mailing Address - Country:US
Mailing Address - Phone:862-223-2004
Mailing Address - Fax:
Practice Address - Street 1:6 POMPTON AVE STE 12
Practice Address - Street 2:
Practice Address - City:CEDAR GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07009-2042
Practice Address - Country:US
Practice Address - Phone:862-330-1727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-18
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL067238001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical