Provider Demographics
NPI:1114249109
Name:AXELROD, KAREN STEPHANIE (PHD CLINICAL PSYCH)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:STEPHANIE
Last Name:AXELROD
Suffix:
Gender:F
Credentials:PHD CLINICAL PSYCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 WEST 57TH ST.
Mailing Address - Street 2:SUITE 1422
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-2211
Mailing Address - Country:US
Mailing Address - Phone:212-397-1444
Mailing Address - Fax:
Practice Address - Street 1:111 WEST 57TH ST
Practice Address - Street 2:SUITE 1422
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2211
Practice Address - Country:US
Practice Address - Phone:212-397-1444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007910103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical