Provider Demographics
NPI:1750818431
Name:BOATES, KAREN SCOTT (LCSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:SCOTT
Last Name:BOATES
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 1:69 COOKS CROSS RD
Mailing Address - Street 2:
Mailing Address - City:PITTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08867-4229
Mailing Address - Country:US
Mailing Address - Phone:908-894-2355
Mailing Address - Fax:908-281-1423
Practice Address - Street 1:69 COOKS CROSS RD
Practice Address - Street 2:
Practice Address - City:PITTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08867-4229
Practice Address - Country:US
Practice Address - Phone:908-894-2355
Practice Address - Fax:908-281-1423
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055642001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical