Provider Demographics
NPI:1851739494
Name:WILLIAMS, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 MAIN ST STE 130-124
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14226-3120
Mailing Address - Country:US
Mailing Address - Phone:716-713-0968
Mailing Address - Fax:716-831-1818
Practice Address - Street 1:3500 MAIN ST STE 130-124
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14226-3120
Practice Address - Country:US
Practice Address - Phone:716-713-0968
Practice Address - Fax:716-831-1818
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical