Provider Demographics
NPI:1376971234
Name:FLANNERY, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:FLANNERY
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:FLANNERY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:520 LOCUST STREET
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720
Mailing Address - Country:US
Mailing Address - Phone:508-679-4333
Mailing Address - Fax:508-679-3833
Practice Address - Street 1:520 LOCUST STREET
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720
Practice Address - Country:US
Practice Address - Phone:508-679-4333
Practice Address - Fax:508-679-3833
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-30
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA115519101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health