Provider Demographics
NPI:1215039664
Name:SHESLER, CARL LAURENCE (DMIN)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:LAURENCE
Last Name:SHESLER
Suffix:
Gender:M
Credentials:DMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MAIN ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940-1818
Mailing Address - Country:US
Mailing Address - Phone:973-722-1799
Mailing Address - Fax:973-822-1018
Practice Address - Street 1:14 MAIN ST
Practice Address - Street 2:SUITE 300
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-1818
Practice Address - Country:US
Practice Address - Phone:973-722-1799
Practice Address - Fax:973-822-1018
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3251101YP1600X
NJ37FI00143000106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist