Provider Demographics
NPI:1881921831
Name:NICHOLSON-MUTH, KAREN CHRISTINE (LMSW)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:CHRISTINE
Last Name:NICHOLSON-MUTH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3070 WHISPERWOOD DR
Mailing Address - Street 2:APT 422
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-3419
Mailing Address - Country:US
Mailing Address - Phone:734-276-2806
Mailing Address - Fax:734-761-5938
Practice Address - Street 1:202 E WASHINGTON ST
Practice Address - Street 2:SUITE 210
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2017
Practice Address - Country:US
Practice Address - Phone:734-276-2806
Practice Address - Fax:734-761-5938
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI68010888731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical