Provider Demographics
NPI:1326251166
Name:CARNEY, KAREN L (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:L
Last Name:CARNEY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 FOOTE PATH LN
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-3115
Mailing Address - Country:US
Mailing Address - Phone:860-680-2842
Mailing Address - Fax:860-563-3475
Practice Address - Street 1:109 MAIN ST
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109
Practice Address - Country:US
Practice Address - Phone:860-680-2842
Practice Address - Fax:860-563-3475
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002300104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
140002300CT01OtherBLUE CROSS
327624OtherMHN
140002300CT01OtherBLUE CROSS