Provider Demographics
NPI:1295023927
Name:NICHOLSON, KAREN BYERLY
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:BYERLY
Last Name:NICHOLSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 WEDGEWOOD GDNS
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-6514
Mailing Address - Country:US
Mailing Address - Phone:570-523-6089
Mailing Address - Fax:
Practice Address - Street 1:1800 MARKET ST
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-1236
Practice Address - Country:US
Practice Address - Phone:570-524-9477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-15
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health