Provider Demographics
NPI:1700194685
Name:WORRELL, KAREN LYNETTE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LYNETTE
Last Name:WORRELL
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 1:10020 MONROE RD STE 170-255
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5485
Mailing Address - Country:US
Mailing Address - Phone:704-806-2170
Mailing Address - Fax:
Practice Address - Street 1:769 N WENDOVER RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1118
Practice Address - Country:US
Practice Address - Phone:704-376-7180
Practice Address - Fax:704-531-9266
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0068761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical