Provider Demographics
NPI:1740369198
Name:SHIPKOVITZ, KAREN S (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:S
Last Name:SHIPKOVITZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 OLD MILL RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-1918
Mailing Address - Country:US
Mailing Address - Phone:412-963-1370
Mailing Address - Fax:412-963-6245
Practice Address - Street 1:1312 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212
Practice Address - Country:US
Practice Address - Phone:412-321-0255
Practice Address - Fax:412-321-3452
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW000547L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SH634580Medicare ID - Type Unspecified
R07719Medicare UPIN