Provider Demographics
NPI:1073270435
Name:ALLEN, KAREN MELINDA (LMSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MELINDA
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 W EMERALD ST STE 180
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-9069
Mailing Address - Country:US
Mailing Address - Phone:208-342-6300
Mailing Address - Fax:
Practice Address - Street 1:8100 W EMERALD ST STE 180
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-9069
Practice Address - Country:US
Practice Address - Phone:208-342-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-33894104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker