Provider Demographics
NPI:1437369121
Name:JOHNSON-CROMWELL, KAREN SONG (PCC-S, LPC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:SONG
Last Name:JOHNSON-CROMWELL
Suffix:
Gender:F
Credentials:PCC-S, LPC
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:SONG
Other - Last Name:CROMWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PCC-S
Mailing Address - Street 1:359 LANSING DR
Mailing Address - Street 2:
Mailing Address - City:MANTUA
Mailing Address - State:NJ
Mailing Address - Zip Code:08051-1236
Mailing Address - Country:US
Mailing Address - Phone:513-348-8485
Mailing Address - Fax:866-629-1075
Practice Address - Street 1:38 COOPER ST
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-4667
Practice Address - Country:US
Practice Address - Phone:513-348-8485
Practice Address - Fax:866-629-1075
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00561900101YM0800X
OHE0007154101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health