Healthcare Provider Details

I. General information

NPI: 1093820383
Provider Name (Legal Business Name): KAREN LORE MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 EMBURY AVE
OCEAN GROVE NJ
07756-1320
US

IV. Provider business mailing address

6 EMBURY AVE
OCEAN GROVE NJ
07756-1320
US

V. Phone/Fax

Practice location:
  • Phone: 732-615-8640
  • Fax:
Mailing address:
  • Phone: 732-615-8640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC00039500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: