Provider Demographics
NPI:1639481633
Name:HOLCOMB, KAREN (LSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:HOLCOMB
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 1:1385 POCONO BLVD
Mailing Address - Street 2:
Mailing Address - City:MOUNT POCONO
Mailing Address - State:PA
Mailing Address - Zip Code:18344-1678
Mailing Address - Country:US
Mailing Address - Phone:570-476-7704
Mailing Address - Fax:570-421-3600
Practice Address - Street 1:400 3RD AVE STE 308
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-5816
Practice Address - Country:US
Practice Address - Phone:570-243-9036
Practice Address - Fax:570-288-0508
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-07
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
PA132189104100000X
PASW132189101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker