Provider Demographics
NPI:1841641131
Name:WIGGINS, KAREN ANN (LISW-S)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ANN
Last Name:WIGGINS
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10112 PLEASANT RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43772-9783
Mailing Address - Country:US
Mailing Address - Phone:740-630-1347
Mailing Address - Fax:
Practice Address - Street 1:209 SENECA AVE
Practice Address - Street 2:
Practice Address - City:BYESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43723-1364
Practice Address - Country:US
Practice Address - Phone:740-685-1610
Practice Address - Fax:740-685-1610
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-28
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.0900359SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH212926Medicaid