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General NPI Number Information
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NPI Number | 1700668381
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Entity Type | Individual
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Provider Name | KAREN PHELAN
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Gender | Female
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Dates
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Enumeration Date | 10/18/2023
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Last Update Date | 10/18/2023
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Provider Practice Location Address
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Address Line | 287 BOULEVARD
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City | POMPTON PLAINS
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State | NJ
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Zip | 07444-1726
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Country | US
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Telephone | 862-660-1118
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Fax |
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Provider Business Mailing Address
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Address Line | 15 ROCKLEDGE TER
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City | WAYNE
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State | NJ
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Zip | 07470-4210
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Country | US
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Telephone | 862-226-1881
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 37AC00722500
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License Number State | NJ
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