Provider Demographics
NPI:1912104282
Name:SHELL, KAREN M (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:M
Last Name:SHELL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:981 TONAWANDA CREEK RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-1257
Mailing Address - Country:US
Mailing Address - Phone:716-859-3764
Mailing Address - Fax:716-859-2560
Practice Address - Street 1:80 GOODRICH ST
Practice Address - Street 2:KALEIDA HEALTH CMHC
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1005
Practice Address - Country:US
Practice Address - Phone:716-859-3764
Practice Address - Fax:716-859-2560
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY068082-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical