1639229297 NPI number — KAREN ELIZABETH KOHN LCSW CADC

Table of content: KAREN ELIZABETH KOHN LCSW CADC (NPI 1639229297)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639229297 NPI number — KAREN ELIZABETH KOHN LCSW CADC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KOHN
Provider First Name:
KAREN
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW CADC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639229297
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16529 COASTAL HWY
Provider Second Line Business Mailing Address:
RED MILL CENTER
Provider Business Mailing Address City Name:
LEWES
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19958-3605
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-645-0115
Provider Business Mailing Address Fax Number:
302-945-4221

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16529 COASTAL HWY
Provider Second Line Business Practice Location Address:
RED MILL CENTER
Provider Business Practice Location Address City Name:
LEWES
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19958-3605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-645-0115
Provider Business Practice Location Address Fax Number:
302-945-4221
Provider Enumeration Date:
01/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  10000672 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1000023219 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10000231176 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".




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