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General NPI Number Information
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NPI Number | 1275809659
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Entity Type | Organization
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Legal Business Name | CAREN E GRANDE LLC
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 11/12/2021
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Provider Practice Location Address
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Address Line | 1385 HIGHWAY 35 STE 274
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City | MIDDLETOWN
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State | NJ
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Zip | 07748-2012
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Country | US
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Telephone | 480-381-2233
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Fax |
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Provider Business Mailing Address
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Address Line | 1385 HIGHWAY 35 STE 274
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City | MIDDLETOWN
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State | NJ
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Zip | 07748-2012
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Country | US
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Telephone | 732-778-6468
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CAREN E GRANDE
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Credential | LCSW
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Telephone | 732-778-6468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC04683500NJ
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License Number State | NJ
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