Provider Demographics
NPI:1407507247
Name:KAREN TINSLEY, A LICENSED CLINICAL SOCIAL WORKER, PROFESSIONAL CORP
Entity Type:Organization
Organization Name:KAREN TINSLEY, A LICENSED CLINICAL SOCIAL WORKER, PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:TINSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:310-922-0044
Mailing Address - Street 1:PO BOX 60391
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91116-6391
Mailing Address - Country:US
Mailing Address - Phone:310-922-0044
Mailing Address - Fax:
Practice Address - Street 1:1605 HOPE ST STE 210
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-2670
Practice Address - Country:US
Practice Address - Phone:310-922-0044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-13
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty