Provider Demographics
NPI:1134804131
Name:REDONDO GARCIA, KAREN (LMSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:REDONDO GARCIA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 GLEN AVE # 1
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-1508
Mailing Address - Country:US
Mailing Address - Phone:347-447-1303
Mailing Address - Fax:
Practice Address - Street 1:129 GLEN AVE # 1
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-1508
Practice Address - Country:US
Practice Address - Phone:347-447-1303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1142041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical