Provider Demographics
NPI:1093820383
Name:LORE, KAREN (MSW)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:LORE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MUNICIPAL PLZ
Mailing Address - Street 2:ROOM 213
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-3470
Mailing Address - Country:US
Mailing Address - Phone:973-680-4025
Mailing Address - Fax:973-680-4825
Practice Address - Street 1:1 MUNICIPAL PLZ
Practice Address - Street 2:ROOM 213
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-3470
Practice Address - Country:US
Practice Address - Phone:973-680-4017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC000395001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ636718Medicare ID - Type Unspecified