Provider Demographics
NPI:1629101738
Name:GAGLIANO, KAREN L (LPC)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:L
Last Name:GAGLIANO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44502-1037
Mailing Address - Country:US
Mailing Address - Phone:330-744-2991
Mailing Address - Fax:330-744-2971
Practice Address - Street 1:611 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44502-1037
Practice Address - Country:US
Practice Address - Phone:330-744-2991
Practice Address - Fax:330-744-2971
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0000995101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1629101738Medicaid