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General NPI Number Information
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NPI Number | 1821129354
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Entity Type | Individual
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Provider Name | KAREN MULGRUM LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 07/23/2013
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Provider Practice Location Address
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Address Line | 4122 RTE 516 STE C AND D STRESS CARE OF NEW JERSEY
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City | MATAWAN
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State | NJ
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Zip | 07747
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Country | US
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Telephone | 732-679-4500
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Fax | 732-679-4549
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Provider Business Mailing Address
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Address Line | 48 HIDDEN HARBOR DR
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City | POINT PLEASANT BORO
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State | NJ
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Zip | 08742-4842
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Country | US
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Telephone | 732-701-1340
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05420000
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License Number State | NJ
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