Healthcare Provider Details

I. General information

NPI: 1558814376
Provider Name (Legal Business Name): CARA KASLER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2016
Last Update Date: 07/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 BEAUVOIR AVE C/O EATING DISORDER
SUMMIT NJ
07901-3533
US

IV. Provider business mailing address

99 BEAUVOIR AVE C/O EATING DISORDER
SUMMIT NJ
07901-3533
US

V. Phone/Fax

Practice location:
  • Phone: 908-522-5778
  • Fax: 908-522-5779
Mailing address:
  • Phone: 908-522-5778
  • Fax: 908-522-5779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05219100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: