Provider Demographics
NPI:1003914672
Name:LEIPOLD, KARYN ANNE (MSW LCSW CADC)
Entity Type:Individual
Prefix:MS
First Name:KARYN
Middle Name:ANNE
Last Name:LEIPOLD
Suffix:
Gender:F
Credentials:MSW LCSW CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69B NORTH MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DEEP RIVER
Mailing Address - State:CT
Mailing Address - Zip Code:06417
Mailing Address - Country:US
Mailing Address - Phone:860-395-8410
Mailing Address - Fax:
Practice Address - Street 1:190 WESTBROOK RD
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:CT
Practice Address - Zip Code:06426
Practice Address - Country:US
Practice Address - Phone:860-767-0147
Practice Address - Fax:860-767-0148
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker