Provider Demographics
NPI:1740257294
Name:ABBOTT, KAREN ELIZABETH (LMSW ACP)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ELIZABETH
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:LMSW ACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 62
Mailing Address - Street 2:
Mailing Address - City:BARKER
Mailing Address - State:TX
Mailing Address - Zip Code:77413-0062
Mailing Address - Country:US
Mailing Address - Phone:832-358-5555
Mailing Address - Fax:713-263-0333
Practice Address - Street 1:9525 KATY FRWY
Practice Address - Street 2:STE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024
Practice Address - Country:US
Practice Address - Phone:832-358-5555
Practice Address - Fax:713-263-0333
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17157103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00S36TMedicare ID - Type Unspecified