Provider Demographics
NPI:1255053013
Name:AKE, KAREN LYNN (LMSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:LYNN
Last Name:AKE
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 1:620 COLONIAL PARK DR # 100
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-3746
Mailing Address - Country:US
Mailing Address - Phone:515-707-8627
Mailing Address - Fax:
Practice Address - Street 1:620 COLONIAL PARK DR # 100
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-3746
Practice Address - Country:US
Practice Address - Phone:470-491-3851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW008951104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker