Provider Demographics
NPI:1245875210
Name:MUELLER, CARLA PELOSI I (LCSW)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:PELOSI
Last Name:MUELLER
Suffix:I
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 1:31 SALTERS FARM RD
Mailing Address - Street 2:
Mailing Address - City:CALIFON
Mailing Address - State:NJ
Mailing Address - Zip Code:07830-3420
Mailing Address - Country:US
Mailing Address - Phone:917-750-9956
Mailing Address - Fax:
Practice Address - Street 1:319 MAPLE ST
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-4101
Practice Address - Country:US
Practice Address - Phone:732-324-8200
Practice Address - Fax:732-826-3549
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052654001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty