Provider Demographics
NPI:1568041788
Name:BERUBE, KARYN W (LCSW)
Entity Type:Individual
Prefix:
First Name:KARYN
Middle Name:W
Last Name:BERUBE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KARYN
Other - Middle Name:A
Other - Last Name:WAGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:200 PRESIDENTIAL WAY UNIT 2315
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-0067
Mailing Address - Country:US
Mailing Address - Phone:781-733-3089
Mailing Address - Fax:
Practice Address - Street 1:173 CHELSEA ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:MA
Practice Address - Zip Code:02149-4632
Practice Address - Country:US
Practice Address - Phone:781-733-3089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool