Provider Demographics
NPI:1063054070
Name:WHITFORD, KAREN DONOHUE (LMSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:DONOHUE
Last Name:WHITFORD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7625 W PORT BAY RD
Mailing Address - Street 2:
Mailing Address - City:WOLCOTT
Mailing Address - State:NY
Mailing Address - Zip Code:14590-9419
Mailing Address - Country:US
Mailing Address - Phone:315-401-5002
Mailing Address - Fax:
Practice Address - Street 1:317 W 1ST ST STE 112
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-3678
Practice Address - Country:US
Practice Address - Phone:315-216-6862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-10
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ300112091041C0700X
NY09678311041C0700X
MA2273351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical