Provider Demographics
NPI:1407127699
Name:GELLER, KAREN FERN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:FERN
Last Name:GELLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1271 94TH ST
Mailing Address - Street 2:
Mailing Address - City:BAY HARBOR ISLANDS
Mailing Address - State:FL
Mailing Address - Zip Code:33154-1901
Mailing Address - Country:US
Mailing Address - Phone:305-609-3433
Mailing Address - Fax:
Practice Address - Street 1:1948 NE 123RD ST
Practice Address - Street 2:SUITE 107
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2800
Practice Address - Country:US
Practice Address - Phone:305-609-3433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 46131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical