Provider Demographics
NPI:1578816203
Name:BOONE, KAREN M (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:M
Last Name:BOONE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 YORK RD
Mailing Address - Street 2:SUITE 201-205
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-3041
Mailing Address - Country:US
Mailing Address - Phone:443-438-9723
Mailing Address - Fax:443-438-9724
Practice Address - Street 1:5900 YORK RD
Practice Address - Street 2:SUITE 201-205
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212
Practice Address - Country:US
Practice Address - Phone:443-438-9723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14489104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD14489Medicaid