Provider Demographics
NPI:1669016291
Name:KAREN CONLON THERAPY LCSW PLLC
Entity Type:Organization
Organization Name:KAREN CONLON THERAPY LCSW PLLC
Other - Org Name:COHESIVE THERAPY NYC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:JACKELINE
Authorized Official - Last Name:CONLON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:347-704-0632
Mailing Address - Street 1:11120 75TH RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-6337
Mailing Address - Country:US
Mailing Address - Phone:347-707-0632
Mailing Address - Fax:
Practice Address - Street 1:59 E 54TH ST RM 84
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-9205
Practice Address - Country:US
Practice Address - Phone:646-299-3979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-06
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1669016291OtherINSURANCE CARRIERS