Provider Demographics
NPI:1508087628
Name:LILIENTHAL, KAREN LOUISE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LOUISE
Last Name:LILIENTHAL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6269 HEATHCLIFF DRIVE
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608
Mailing Address - Country:US
Mailing Address - Phone:916-967-9508
Mailing Address - Fax:916-967-9508
Practice Address - Street 1:106 L STREET
Practice Address - Street 2:#5
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814
Practice Address - Country:US
Practice Address - Phone:916-342-7064
Practice Address - Fax:916-967-9508
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS12360104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker