Provider Demographics
NPI:1841420783
Name:KASPER, CAROLYN (LCSW)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:KASPER
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 1:268 MARSHALLVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:NJ
Mailing Address - Zip Code:08270-3323
Mailing Address - Country:US
Mailing Address - Phone:609-827-7009
Mailing Address - Fax:
Practice Address - Street 1:72B TUCKAHOE RD
Practice Address - Street 2:
Practice Address - City:MARMORA
Practice Address - State:NJ
Practice Address - Zip Code:08223-1206
Practice Address - Country:US
Practice Address - Phone:609-827-7009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-24
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC004871001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical