Provider Demographics
NPI:1083933899
Name:MCINTYRE, KAREN FAYE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:FAYE
Last Name:MCINTYRE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11076 E KIVA RIDGE PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85748-3573
Mailing Address - Country:US
Mailing Address - Phone:520-891-1725
Mailing Address - Fax:
Practice Address - Street 1:2450 E SPEEDWAY BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-4734
Practice Address - Country:US
Practice Address - Phone:520-891-1725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW129081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical