Provider Demographics
NPI:1043476849
Name:MOORE, KAREN D (LCSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:D
Last Name:MOORE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:DIANE
Other - Last Name:BALLREICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3540 S HIGHWAY 27
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-3119
Mailing Address - Country:US
Mailing Address - Phone:606-679-1815
Mailing Address - Fax:606-451-1631
Practice Address - Street 1:3540 S HIGHWAY 27
Practice Address - Street 2:SUITE 4
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-3119
Practice Address - Country:US
Practice Address - Phone:606-679-1815
Practice Address - Fax:606-451-1631
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker