Provider Demographics
NPI:1710111901
Name:MULVEY, KAREN ADELE (LCSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ADELE
Last Name:MULVEY
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 1:763 E 3RD AVE APT C
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07203-3661
Mailing Address - Country:US
Mailing Address - Phone:908-347-7399
Mailing Address - Fax:
Practice Address - Street 1:763 E 3RD AVE APT C
Practice Address - Street 2:
Practice Address - City:ROSELLE
Practice Address - State:NJ
Practice Address - Zip Code:07203-3661
Practice Address - Country:US
Practice Address - Phone:908-347-7399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC008813001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical