Provider Demographics
NPI:1326395591
Name:GESICKI, KAREN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:GESICKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N MAIN ST
Mailing Address - Street 2:BLDG. 1, SUITE 3
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-3730
Mailing Address - Country:US
Mailing Address - Phone:609-597-3424
Mailing Address - Fax:609-597-3410
Practice Address - Street 1:400 N MAIN ST
Practice Address - Street 2:BLDG. 1, SUITE 3
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-3730
Practice Address - Country:US
Practice Address - Phone:609-597-3424
Practice Address - Fax:609-597-3410
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-07
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055114001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical