Basic Information
| Provider Information | |||||||||
| NPI: | 1093435000 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCLOONE | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | MARIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 831 RAMAH RD | ||||||||
| Address2: | |||||||||
| City: | MILLVILLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 083327623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6095013126 | ||||||||
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| Practice Location | |||||||||
| Address1: | 42 DELSEA DR S | ||||||||
| Address2: | |||||||||
| City: | GLASSBORO | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080282621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8444223632 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2022 | ||||||||
| LastUpdateDate: | 08/30/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.