Provider Demographics
NPI:1437832045
Name:SMALL, KAREN (LMHC-A)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:SMALL
Suffix:
Gender:F
Credentials:LMHC-A
Other - Prefix:
Other - First Name:KC
Other - Middle Name:
Other - Last Name:SMALL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC-A
Mailing Address - Street 1:1130 TEN ROD RD STE C104
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-4127
Mailing Address - Country:US
Mailing Address - Phone:401-480-0178
Mailing Address - Fax:
Practice Address - Street 1:1130 TEN ROD RD STE C104
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4127
Practice Address - Country:US
Practice Address - Phone:401-216-5181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00099-A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health