Provider Demographics
NPI:1396011375
Name:MADURA, KAREN L (LCSW, LCADC)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:L
Last Name:MADURA
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 985
Mailing Address - Street 2:1140 BLOOMFIELD AVENUE SUITE # 202
Mailing Address - City:WEST CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07007-0985
Mailing Address - Country:US
Mailing Address - Phone:973-865-7180
Mailing Address - Fax:
Practice Address - Street 1:1140 BLOOMFIELD AVE
Practice Address - Street 2:SUITE # 202
Practice Address - City:WEST CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-7130
Practice Address - Country:US
Practice Address - Phone:973-865-7180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00113200101YA0400X
NJ44SC001717001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)