Healthcare Provider Details

I. General information

NPI: 1215039664
Provider Name (Legal Business Name): CARL LAURENCE SHESLER D.MIN.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 MAIN ST SUITE 300
MADISON NJ
07940-1818
US

IV. Provider business mailing address

14 MAIN ST SUITE 300
MADISON NJ
07940-1818
US

V. Phone/Fax

Practice location:
  • Phone: 973-722-1799
  • Fax: 973-822-1018
Mailing address:
  • Phone: 973-722-1799
  • Fax: 973-822-1018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number3251
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number37FI00143000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: