Provider Demographics
NPI:1255842258
Name:HESS, KAREN R (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:R
Last Name:HESS
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 1:113 MERCHANTS PATH
Mailing Address - Street 2:
Mailing Address - City:WAINSCOTT
Mailing Address - State:NY
Mailing Address - Zip Code:11975-1466
Mailing Address - Country:US
Mailing Address - Phone:631-987-7964
Mailing Address - Fax:631-537-3758
Practice Address - Street 1:113 MERCHANTS PATH
Practice Address - Street 2:
Practice Address - City:WAINSCOTT
Practice Address - State:NY
Practice Address - Zip Code:11975-1466
Practice Address - Country:US
Practice Address - Phone:631-987-7964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR043853-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical