Provider Demographics
NPI:1467784082
Name:KARL, MICHAEL J (MHS LCADC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:KARL
Suffix:
Gender:M
Credentials:MHS LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 ELM ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-3104
Mailing Address - Country:US
Mailing Address - Phone:973-204-0275
Mailing Address - Fax:
Practice Address - Street 1:318 ELM ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-3104
Practice Address - Country:US
Practice Address - Phone:973-204-0275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-07
Last Update Date:2010-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00152100101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)