Provider Demographics
NPI:1740620236
Name:JACOB, KAREN SARAH (LCSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:SARAH
Last Name:JACOB
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 1:63 FALMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-1503
Mailing Address - Country:US
Mailing Address - Phone:973-467-8755
Mailing Address - Fax:973-467-8754
Practice Address - Street 1:256 COLUMBIA TPKE
Practice Address - Street 2:SUITE 105
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1209
Practice Address - Country:US
Practice Address - Phone:973-765-9050
Practice Address - Fax:973-765-0195
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055203001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical