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General NPI Number Information
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NPI Number | 1558177519
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Entity Type | Individual
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Provider Name | KASEY CARMELLA OERTEL MA,LAMFT
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Gender | Female
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 286 E MAIN ST
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City | SOMERVILLE
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State | NJ
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Zip | 08876-3006
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Country | US
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Telephone | 908-704-0011
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Fax |
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Provider Business Mailing Address
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Address Line | 286 E MAIN ST
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City | SOMERVILLE
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State | NJ
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Zip | 08876-3006
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Country | US
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Telephone | 908-704-0011
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 37FA00047200
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License Number State | NJ
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