=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679801468
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BARBARA JEAN KACHUR KARAVITES LCSW LCADC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/07/2009
-----------------------------------------------------
Last Update Date | 12/07/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17 SENIOR ST
-----------------------------------------------------
City | NEW BRUNSWICK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08901-8534
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-932-7884
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 784 SYCAMORE AVE
-----------------------------------------------------
City | TINTON FALLS
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07701-4923
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-741-3949
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | 37LC00034000
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 44SC00382900
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------