Provider Demographics
NPI:1659661205
Name:KARL, NANCY D (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:D
Last Name:KARL
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:NAN
Other - Middle Name:D
Other - Last Name:KARL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:6210 ODELL ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63139-2616
Mailing Address - Country:US
Mailing Address - Phone:314-647-6109
Mailing Address - Fax:
Practice Address - Street 1:225 S MERAMEC AVE
Practice Address - Street 2:SUITE 406
Practice Address - City:CLAYTON
Practice Address - State:MO
Practice Address - Zip Code:63105-3511
Practice Address - Country:US
Practice Address - Phone:314-873-8308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-17
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20050319401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical