Provider Demographics
NPI:1356571582
Name:KARP, TINA C (LISW)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:C
Last Name:KARP
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 N LEAVITT RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001-1126
Mailing Address - Country:US
Mailing Address - Phone:440-984-3882
Mailing Address - Fax:440-984-3883
Practice Address - Street 1:315 N LEAVITT RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-1126
Practice Address - Country:US
Practice Address - Phone:440-984-3882
Practice Address - Fax:440-984-3883
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.0027933104100000X
OHI. 12002441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0268768Medicaid