Provider Demographics
NPI:1356327332
Name:SALZARULO RATTAN, KAREN JEAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:JEAN
Last Name:SALZARULO RATTAN
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 1:761 MAIN AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-1080
Mailing Address - Country:US
Mailing Address - Phone:203-855-9691
Mailing Address - Fax:203-855-7743
Practice Address - Street 1:761 MAIN AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-1080
Practice Address - Country:US
Practice Address - Phone:203-855-9691
Practice Address - Fax:203-855-7743
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0014101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT800003379Medicare ID - Type UnspecifiedMEDICARE