Provider Demographics
NPI:1336021567
Name:KOWALEWSKI, CARLY NICOLE (MC, NCC, LAC)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:NICOLE
Last Name:KOWALEWSKI
Suffix:
Gender:F
Credentials:MC, NCC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 SHIP AVE
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08722-2321
Mailing Address - Country:US
Mailing Address - Phone:732-228-0789
Mailing Address - Fax:
Practice Address - Street 1:1198 LAKEWOOD RD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2243
Practice Address - Country:US
Practice Address - Phone:732-605-6364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00887300101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor