Provider Demographics
NPI:1275015018
Name:LEE, KAREN (MSW LICSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 CAPTAIN RD
Mailing Address - Street 2:
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-2546
Mailing Address - Country:US
Mailing Address - Phone:413-530-7277
Mailing Address - Fax:
Practice Address - Street 1:200 HILLSIDE CIR STE 3
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-4681
Practice Address - Country:US
Practice Address - Phone:413-827-4218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1032480-SW-LICSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical