Provider Demographics
NPI:1578929261
Name:KAREN BOGART, MS.,, LMHC., PA
Entity Type:Organization
Organization Name:KAREN BOGART, MS.,, LMHC., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGART
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:407-629-1775
Mailing Address - Street 1:235 S MAITLAND AVE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-5677
Mailing Address - Country:US
Mailing Address - Phone:407-629-1775
Mailing Address - Fax:
Practice Address - Street 1:235 S MAITLAND AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-5677
Practice Address - Country:US
Practice Address - Phone:407-629-1775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-11
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty