Provider Demographics
NPI:1518136969
Name:EDWARDS-D'ALESSANDRO, KAREN (LCSW-R)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:EDWARDS-D'ALESSANDRO
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1462 ERIE BLVD
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12305-1026
Mailing Address - Country:US
Mailing Address - Phone:518-243-1020
Mailing Address - Fax:518-243-1021
Practice Address - Street 1:624 MCCLELLAN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12304-1020
Practice Address - Country:US
Practice Address - Phone:518-382-2290
Practice Address - Fax:518-382-2292
Is Sole Proprietor?:No
Enumeration Date:2008-02-29
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR053405104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00053402Medicaid
NY00053402Medicaid