Provider Demographics
NPI:1063779734
Name:ZITTLEMAN, KAREN (LCSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:ZITTLEMAN
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 1:2112 BIENVILLE BLVD STE K
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-3067
Mailing Address - Country:US
Mailing Address - Phone:228-819-2171
Mailing Address - Fax:228-205-4986
Practice Address - Street 1:900 MAGNOLIA BAYOU BLVD
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-8391
Practice Address - Country:US
Practice Address - Phone:228-326-7575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC37681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical