Provider Demographics
NPI:1689897332
Name:DALE, KAREN THOMPSON (LICSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:THOMPSON
Last Name:DALE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 PARKLAND DR
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01778-4729
Mailing Address - Country:US
Mailing Address - Phone:508-655-9007
Mailing Address - Fax:
Practice Address - Street 1:950 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02141-1001
Practice Address - Country:US
Practice Address - Phone:617-441-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1057801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical