Provider Demographics
NPI:1972272227
Name:BAKELAAR, CAROL ANN (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:BAKELAAR
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:ANN
Other - Last Name:CAVANAGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:381 ATLANTIS AVE
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2064
Mailing Address - Country:US
Mailing Address - Phone:609-618-9171
Mailing Address - Fax:
Practice Address - Street 1:226 MAIN ST
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7469
Practice Address - Country:US
Practice Address - Phone:732-244-1600
Practice Address - Fax:732-349-5532
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06548500104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker