Provider Demographics
NPI:1902046030
Name:NOLEN, KAREN W (LICSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:W
Last Name:NOLEN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 625
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01061-0625
Mailing Address - Country:US
Mailing Address - Phone:413-658-7514
Mailing Address - Fax:413-397-3366
Practice Address - Street 1:110 N HILLSIDE RD STE 3
Practice Address - Street 2:
Practice Address - City:SOUTH DEERFIELD
Practice Address - State:MA
Practice Address - Zip Code:01373-9727
Practice Address - Country:US
Practice Address - Phone:413-658-7514
Practice Address - Fax:413-397-3366
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1146331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0010452Medicare PIN