Provider Demographics
NPI:1780320218
Name:STEPHENS, CAROLYN (LPC, ACS)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:LPC, ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 E SHORE RD
Mailing Address - Street 2:
Mailing Address - City:LAKE HOPATCONG
Mailing Address - State:NJ
Mailing Address - Zip Code:07849-1770
Mailing Address - Country:US
Mailing Address - Phone:908-692-8542
Mailing Address - Fax:
Practice Address - Street 1:25 E SHORE RD
Practice Address - Street 2:
Practice Address - City:LAKE HOPATCONG
Practice Address - State:NJ
Practice Address - Zip Code:07849-1770
Practice Address - Country:US
Practice Address - Phone:908-692-8542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-08
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00367900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional