Provider Demographics
NPI:1144574393
Name:MCMAHON, KAREN A
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 DES PERES RD
Mailing Address - Street 2:SUITE 200-C
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2050
Mailing Address - Country:US
Mailing Address - Phone:314-729-4600
Mailing Address - Fax:314-729-4636
Practice Address - Street 1:1000 DES PERES RD
Practice Address - Street 2:SUITE 200-C
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2050
Practice Address - Country:US
Practice Address - Phone:314-729-4600
Practice Address - Fax:314-729-4636
Is Sole Proprietor?:No
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0017741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical