Dorian Jane Kavanagh | Englewood, NJ • PECOS Search

Dorian Jane Kavanagh

Social Worker

Behavioral Health & Social Service Providers

342 Grand Ave Fl 2, Englewood, NJ 07631-4355

(973) 327-3445 (917) 923-5497

PECOS Enrollment

Based on the most recent information from CMS, provider Dorian Jane Kavanagh does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1750622148
Provider Type
Individual
Full Name
Kavanagh, Dorian Jane
Credential
LCSW

Gender
Female
Sole Proprietor
Yes
Enumeration Date
3/8/2013
Last Updated
7/27/2022

Contact Information

Practice Location

342 Grand Ave Fl 2, Englewood, NJ 07631-4355

Unlisted Fax

Mailing Location

PO Box 186, Tenafly, NJ 07670-0186

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 44SC05497900 New Jersey