Provider Demographics
NPI:1962863027
Name:CALLEN, KAREN (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:CALLEN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 BAY RIDGE AVE
Mailing Address - Street 2:SUITE 340
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21403-2835
Mailing Address - Country:US
Mailing Address - Phone:410-295-1539
Mailing Address - Fax:
Practice Address - Street 1:1819 BAY RIDGE AVE
Practice Address - Street 2:SUITE 340
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21403-2835
Practice Address - Country:US
Practice Address - Phone:410-295-1539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD070111041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical