Provider Demographics
NPI:1255656393
Name:TRAYLOR-ADOLPH, KAREN B (PHD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:B
Last Name:TRAYLOR-ADOLPH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:B
Other - Last Name:TRAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1123 CLAIREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1207
Mailing Address - Country:US
Mailing Address - Phone:678-837-6529
Mailing Address - Fax:404-800-0051
Practice Address - Street 1:1123 CLAIREMONT AVE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1207
Practice Address - Country:US
Practice Address - Phone:678-837-6529
Practice Address - Fax:404-800-0051
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-31
Last Update Date:2025-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004083101YM0800X
GAPSY004385103T00000X, 103TC0700X
MO2018030709103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist