Provider Demographics
NPI:1710417472
Name:KARIN I. GRUSS LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:KARIN I. GRUSS LIMITED LIABILITY COMPANY
Other - Org Name:KARIN I. GRUSS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KARIN
Authorized Official - Middle Name:I
Authorized Official - Last Name:GRUSS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW LCADC
Authorized Official - Phone:908-343-0073
Mailing Address - Street 1:6 E MAIN ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809-2627
Mailing Address - Country:US
Mailing Address - Phone:908-343-0073
Mailing Address - Fax:
Practice Address - Street 1:6 EAST MAIN STREET
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809
Practice Address - Country:US
Practice Address - Phone:908-343-0073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05314100261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)