Provider Demographics
NPI:1861504391
Name:AMON, KAREN GERMAIN (LBSW, CACII)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:GERMAIN
Last Name:AMON
Suffix:
Gender:F
Credentials:LBSW, CACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 N MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-5929
Mailing Address - Country:US
Mailing Address - Phone:989-895-9080
Mailing Address - Fax:989-895-7914
Practice Address - Street 1:1301 N MADISON AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-5929
Practice Address - Country:US
Practice Address - Phone:989-895-9080
Practice Address - Fax:989-895-7914
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI090074101YA0400X
MI6802069480104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker