Provider Demographics
NPI:1104425719
Name:CASTRO, KAREN (MDIV, LSW)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:CASTRO
Suffix:
Gender:F
Credentials:MDIV, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 US HIGHWAY 22 APT 21
Mailing Address - Street 2:
Mailing Address - City:NORTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-3567
Mailing Address - Country:US
Mailing Address - Phone:908-565-3238
Mailing Address - Fax:
Practice Address - Street 1:193 ROUTE 9 STE 2D
Practice Address - Street 2:
Practice Address - City:ENGLISHTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3016
Practice Address - Country:US
Practice Address - Phone:732-590-5240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL060970001041S0200X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool