Provider Demographics
NPI:1932674868
Name:HUMPHREY, KARIN ELIZABETH (LSW)
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:ELIZABETH
Last Name:HUMPHREY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 CURTIS ST
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-2442
Mailing Address - Country:US
Mailing Address - Phone:740-272-3158
Mailing Address - Fax:
Practice Address - Street 1:740 CURTIS ST
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-2442
Practice Address - Country:US
Practice Address - Phone:740-272-3158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
S.1701439104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker