Provider Demographics
NPI:1295922169
Name:MCGRELLIS, KAREN (MA, LPC, CTS)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MCGRELLIS
Suffix:
Gender:F
Credentials:MA, LPC, CTS
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:MCGRELLIS MIHATOV
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LPC, CTS
Mailing Address - Street 1:320 AMBOY AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2469
Mailing Address - Country:US
Mailing Address - Phone:732-205-0092
Mailing Address - Fax:
Practice Address - Street 1:320 AMBOY AVE
Practice Address - Street 2:SUITE B
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2469
Practice Address - Country:US
Practice Address - Phone:732-205-0092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00096900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health