Provider Demographics
NPI:1265473961
Name:KAUFFMAN, KAREN E (LCSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:E
Last Name:KAUFFMAN
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:RR 1 BOX 168
Mailing Address - Street 2:
Mailing Address - City:DORNSIFE
Mailing Address - State:PA
Mailing Address - Zip Code:17823-9610
Mailing Address - Country:US
Mailing Address - Phone:570-425-2371
Mailing Address - Fax:570-524-9492
Practice Address - Street 1:32 WHISPER CREEK DR
Practice Address - Street 2:SUITE 7
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-7770
Practice Address - Country:US
Practice Address - Phone:570-522-0304
Practice Address - Fax:570-522-0304
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW-123557104100000X
PACW0153801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50044331OtherCAPITAL BLUE CROSS