Healthcare Provider Details

I. General information

NPI: 1396727053
Provider Name (Legal Business Name): CAROL RASHER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1184 MAIN ST
RIVER EDGE NJ
07661-2532
US

IV. Provider business mailing address

1184 MAIN ST
RIVER EDGE NJ
07661-2532
US

V. Phone/Fax

Practice location:
  • Phone: 201-487-6233
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number025200R
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: