Provider Demographics
NPI:1821129354
Name:MULGRUM, KAREN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:MULGRUM
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 1:48 HIDDEN HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT BORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-4842
Mailing Address - Country:US
Mailing Address - Phone:732-701-1340
Mailing Address - Fax:
Practice Address - Street 1:4122 RTE 516 STE C AND D
Practice Address - Street 2:STRESS CARE OF NEW JERSEY
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747
Practice Address - Country:US
Practice Address - Phone:732-679-4500
Practice Address - Fax:732-679-4549
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054200001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0029807Medicaid