Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 37PC00198200 | NJ |
NPI | 1962954149 |
---|---|
Provider Name | John K. Carey |
First Address | Ship Bottom, NJ 08008-4753 |
Second Address | Ship Bottom, NJ 08008-4753 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2016 |
Last Update Date | 03/11/2016 |