Provider Demographics
NPI:1295397040
Name:GARRISON, KAREN (CDCA, LPN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:GARRISON
Suffix:
Gender:F
Credentials:CDCA, LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3621 ROSSGATE CT
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-9558
Mailing Address - Country:US
Mailing Address - Phone:513-738-7600
Mailing Address - Fax:513-738-7601
Practice Address - Street 1:3621 ROSSGATE CT
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-9558
Practice Address - Country:US
Practice Address - Phone:513-738-7600
Practice Address - Fax:513-738-7601
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.328476163W00000X
OHCDCA.168281101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No163W00000XNursing Service ProvidersRegistered Nurse