Mikkelsen, Dennis

Mikkelsen, Dennis is an sole proprietor health care provider with primary practice located at 601 Broadway , Bayonne NJ 07002-3818. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Mikkelsen, Dennis can be contacted via phone (201) 339-9200.

Contact Information

Primary practice address
601 Broadway Bayonne NJ 07002-3818
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 44SC04809100 New Jersey

Profile Details

NPI number 1154473213
LBN Legal business name Mikkelsen, Dennis
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 17th, 2007
Last updated Nov 16th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154473213 NPPES
New Jersey MEDICAID 0021806

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