Provider Demographics
NPI:1598478737
Name:CERASO, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:CERASO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 ROOSEVELT PL APT A3
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-3342
Mailing Address - Country:US
Mailing Address - Phone:802-673-4563
Mailing Address - Fax:
Practice Address - Street 1:595 COUNTY AVE BLDG 61
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-2605
Practice Address - Country:US
Practice Address - Phone:201-583-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT151.0134128101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)