Provider Demographics
NPI:1295982551
Name:REISS, KAREN (LSW)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:REISS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018
Mailing Address - Country:US
Mailing Address - Phone:610-861-8779
Mailing Address - Fax:
Practice Address - Street 1:147 E BROAD ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018
Practice Address - Country:US
Practice Address - Phone:610-861-8779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW126235104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker