Provider Demographics
NPI:1336169564
Name:SALLEE, KAREN J (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:J
Last Name:SALLEE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:468 RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:KY
Mailing Address - Zip Code:41339-9201
Mailing Address - Country:US
Mailing Address - Phone:606-666-2328
Mailing Address - Fax:606-666-2320
Practice Address - Street 1:468 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:KY
Practice Address - Zip Code:41339-9201
Practice Address - Country:US
Practice Address - Phone:606-666-2328
Practice Address - Fax:606-666-2777
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY8200066200Medicaid
KY468Medicare UPIN
KY8200066200Medicaid