Provider Demographics
NPI:1184636573
Name:CONNORS, KAREN M (ACSW,LICSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:CONNORS
Suffix:
Gender:F
Credentials:ACSW,LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 TEN ROD RD
Mailing Address - Street 2:SUITE D104
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-4161
Mailing Address - Country:US
Mailing Address - Phone:401-295-5575
Mailing Address - Fax:401-295-5552
Practice Address - Street 1:1130 TEN ROD RD
Practice Address - Street 2:SUITE D104
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4161
Practice Address - Country:US
Practice Address - Phone:401-295-5575
Practice Address - Fax:401-295-5552
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW004361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI62-25675OtherUBH
RIKC04097Medicaid
RI1038100OtherBEACON HEALTH STRATEGIES
RI9367-3OtherRI BLUE CROSS
RI246128OtherMAGELLAN BEH CARE
RI384434OtherVALUE OPTIONS
RI406748OtherRI BLUE CHIP
RI9009367Medicaid