Clifford M Koblin, LPC, LCADC
Individual provider Active NPI Professional Counselor · Kingston, NJ
NPI 1396868071 · NPPES record last updated Oct 20, 2009
Key facts
- NPI
- 1396868071
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 37PC000336400 (NJ)
- Practice address
- 4475 Route 27
Kingston, NJ 08528-9601 - Phone
- (609) 252-1152
- NPI assigned
- Apr 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37LC00090100 | NJ | MD | Addiction (Substance Use Disorder) Counselor |
| 37PC000336400 | NJ | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 37LC00090100 | NJ | |
| Professional Counselor | 101YP2500X | 37PC000336400 | NJ | Yes |
Addresses
Primary practice location
4475 Route 27
Kingston, NJ 08528-9601
Mailing address
130 Spring Hill Rd
Skillman, NJ 08558-1418
Phone (609) 333-1096
Other providers in Kingston, NJ
- Lauren Jaffe
- Joyce C Kawalchuk
- Kelly McGlynn, LLC
- Ummi Kalsoom Khan
- Kingston Implant and Smiles LLC
- Julia Little
- Suzanne Lorant
- James L Mastrich Jr.
- Randy Robert Radd
- Todd E Stevens
All providers in Kingston, NJ · Professional Counselor in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.