MEDICARE: KAREN R. SEARLE LCSW, DCSW, RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	44SC00001600	NJ

General Provider Information

NPI Number	:	1063519320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN R. SEARLE LCSW, DCSW, RN

Provider Business Mailing Address
First Line	:	22 WINDSOR WAY
Second Line	:
City	:	BERKELEY HEIGHTS
State	:	NJ
Zip	:	07922-1857
Country	:	US
Telephone Number	:	908-771-0598
Fax Number	:

Provider Business Practice Location Address
First Line	:	261 SPRINGFIELD AVE
Second Line	:	SUITE 103
City	:	BERKELEY HEIGHTS
State	:	NJ
Zip	:	07922-1264
Country	:	US
Telephone Number	:	908-771-0598
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

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