Provider Demographics
NPI:1881651263
Name:GOTTO, KAREN KAY (LMHC,LMSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:KAY
Last Name:GOTTO
Suffix:
Gender:F
Credentials:LMHC,LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 AMY CIR
Mailing Address - Street 2:
Mailing Address - City:CARROLL
Mailing Address - State:IA
Mailing Address - Zip Code:51401-2630
Mailing Address - Country:US
Mailing Address - Phone:712-260-2700
Mailing Address - Fax:712-276-4917
Practice Address - Street 1:409 KENYON RD
Practice Address - Street 2:SUITE C
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-5718
Practice Address - Country:US
Practice Address - Phone:515-573-3138
Practice Address - Fax:515-573-3130
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00289101YM0800X
IA02755104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker