Provider Demographics
NPI:1255839130
Name:ALLEN, KAREN M (LCSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:ALLEN
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 1:108 E 5TH AVE STE B
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-3128
Mailing Address - Country:US
Mailing Address - Phone:706-509-0130
Mailing Address - Fax:706-237-6503
Practice Address - Street 1:306 N THORNTON AVE
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-3259
Practice Address - Country:US
Practice Address - Phone:706-509-0130
Practice Address - Fax:706-237-6503
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-25
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0079681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACSW007968OtherLICENSURE