Provider Demographics
NPI:1073606265
Name:LORD, KAREN T (LICSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:T
Last Name:LORD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 LILLIAN ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-1144
Mailing Address - Country:US
Mailing Address - Phone:413-774-7749
Mailing Address - Fax:
Practice Address - Street 1:55 FEDERAL ST STE 200
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2546
Practice Address - Country:US
Practice Address - Phone:413-772-8866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1038461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA103846OtherLICENSE NUMBER
MA103846OtherLICENSE NUMBER