Provider Demographics
NPI:1063519320
Name:SEARLE, KAREN R (LCSW, DCSW, RN)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:R
Last Name:SEARLE
Suffix:
Gender:F
Credentials:LCSW, DCSW, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 WINDSOR WAY
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-1857
Mailing Address - Country:US
Mailing Address - Phone:908-771-0598
Mailing Address - Fax:
Practice Address - Street 1:261 SPRINGFIELD AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:BERKELEY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07922-1264
Practice Address - Country:US
Practice Address - Phone:908-771-0598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC000016001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SE 637484Medicare ID - Type Unspecified
NJS20692Medicare UPIN