Provider Demographics
NPI:1902599814
Name:INGRAM, KAREN (LPC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:INGRAM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 RUTHERFORD BLVD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07014-1409
Mailing Address - Country:US
Mailing Address - Phone:908-265-6263
Mailing Address - Fax:
Practice Address - Street 1:154 RUTHERFORD BLVD
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07014-1409
Practice Address - Country:US
Practice Address - Phone:908-265-6263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-29
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00966000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health