Provider Demographics
NPI:1861032120
Name:KAREN C. FRAGETTA, PH.D., LLC
Entity Type:Organization
Organization Name:KAREN C. FRAGETTA, PH.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:C
Authorized Official - Last Name:FRAGETTA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:410-881-2111
Mailing Address - Street 1:1122 KENILWORTH DR STE 100
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2142
Mailing Address - Country:US
Mailing Address - Phone:410-881-2111
Mailing Address - Fax:410-881-2111
Practice Address - Street 1:1122 KENILWORTH DR STE 100
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2142
Practice Address - Country:US
Practice Address - Phone:410-881-2111
Practice Address - Fax:410-881-2111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-14
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty