Provider Demographics
NPI:1598864472
Name:WOODALL, KAREN LEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LEE
Last Name:WOODALL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 N CRAIG ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-1571
Mailing Address - Country:US
Mailing Address - Phone:412-683-6337
Mailing Address - Fax:412-683-0642
Practice Address - Street 1:155 N CRAIG ST
Practice Address - Street 2:SUITE 120
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-1571
Practice Address - Country:US
Practice Address - Phone:412-683-6337
Practice Address - Fax:412-683-0642
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005592L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA710942OtherHIGHMARK INSURANCE PROVID
NY150153OtherVALUE OPTIONS PROVIDER ID
PA110145OtherUPMC HEALTH PLAN PROVIDER
PA110145OtherUPMC HEALTH PLAN PROVIDER