Provider Demographics
NPI:1023270840
Name:BEARDMAN, KAREN CHARLENE (LISW)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:CHARLENE
Last Name:BEARDMAN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:CHARLENE
Other - Last Name:MASSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4900 BAY GROVE CT
Mailing Address - Street 2:
Mailing Address - City:GROVEPORT
Mailing Address - State:OH
Mailing Address - Zip Code:43125-9257
Mailing Address - Country:US
Mailing Address - Phone:614-836-2708
Mailing Address - Fax:614-752-9304
Practice Address - Street 1:4900 BAY GROVE CT
Practice Address - Street 2:
Practice Address - City:GROVEPORT
Practice Address - State:OH
Practice Address - Zip Code:43125-9257
Practice Address - Country:US
Practice Address - Phone:614-836-2708
Practice Address - Fax:614-752-9304
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-48161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical