Provider Demographics
NPI:1194318253
Name:MAYO, KAREN MARIE (LMSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:MAYO
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 1:75 WEST ST
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-6528
Mailing Address - Country:US
Mailing Address - Phone:203-748-5689
Mailing Address - Fax:
Practice Address - Street 1:35 RUSSELL ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-1312
Practice Address - Country:US
Practice Address - Phone:203-748-5689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT49381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical