Provider Demographics
NPI:1851875256
Name:RICHARDS-TYO, KAREN L (MSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:RICHARDS-TYO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 GOODALE RD
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-1647
Mailing Address - Country:US
Mailing Address - Phone:508-251-1460
Mailing Address - Fax:
Practice Address - Street 1:108 GOODALE RD
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-1647
Practice Address - Country:US
Practice Address - Phone:508-251-1460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical