Provider Demographics
NPI:1558907204
Name:WINKER, KAREN GALLAGHER (LICSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:GALLAGHER
Last Name:WINKER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:GALLAGHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:3850 PARK NICOLLET BLVD # 61W03B
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-2527
Mailing Address - Country:US
Mailing Address - Phone:952-993-6506
Mailing Address - Fax:
Practice Address - Street 1:3850 PARK NICOLLET BLVD # 61W03B
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-2527
Practice Address - Country:US
Practice Address - Phone:952-993-6506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-18
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN97711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical