Provider Demographics
NPI:1336349265
Name:MOON, KAREN K (MSW)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:K
Last Name:MOON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 RADOR CHESTER RD
Mailing Address - Street 2:SUITE F130
Mailing Address - City:RADNOR
Mailing Address - State:PA
Mailing Address - Zip Code:19087
Mailing Address - Country:US
Mailing Address - Phone:610-687-4274
Mailing Address - Fax:
Practice Address - Street 1:150 RADOR CHESTER RD
Practice Address - Street 2:SUITE F130
Practice Address - City:RADNOR
Practice Address - State:PA
Practice Address - Zip Code:19087
Practice Address - Country:US
Practice Address - Phone:610-687-4274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0147011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical