Provider Demographics
NPI:1285864850
Name:SAINT CLARE'S HEALTH SYSTEM
Entity Type:Organization
Organization Name:SAINT CLARE'S HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:KERLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CASADO
Authorized Official - Suffix:
Authorized Official - Credentials:LCADC, LSW
Authorized Official - Phone:973-625-7029
Mailing Address - Street 1:50 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-1735
Mailing Address - Country:US
Mailing Address - Phone:973-625-7029
Mailing Address - Fax:
Practice Address - Street 1:50 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-1735
Practice Address - Country:US
Practice Address - Phone:973-625-7029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00118700261QM0850X
NJ44SL05263400261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health