Provider Demographics
NPI:1750642104
Name:GOREN, KAREN CHRISTEL (LCSW, CGP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:CHRISTEL
Last Name:GOREN
Suffix:
Gender:F
Credentials:LCSW, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 E FRONT ST
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-2936
Mailing Address - Country:US
Mailing Address - Phone:610-507-9905
Mailing Address - Fax:610-566-3351
Practice Address - Street 1:36 E FRONT ST
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2936
Practice Address - Country:US
Practice Address - Phone:610-507-9905
Practice Address - Fax:610-566-3351
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-01
Last Update Date:2017-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0178321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical