Provider Demographics
NPI:1740299023
Name:NOVAK, KAREN D (PHD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:D
Last Name:NOVAK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5217 HILLMONT CT
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-7089
Mailing Address - Country:US
Mailing Address - Phone:410-313-9257
Mailing Address - Fax:410-313-9142
Practice Address - Street 1:124 W FRANKLIN ST
Practice Address - Street 2:SUITE 008
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-4576
Practice Address - Country:US
Practice Address - Phone:410-539-8800
Practice Address - Fax:410-313-9142
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD117861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD030SMedicare ID - Type UnspecifiedCLINICAL SOCIAL WORKER