Provider Demographics
NPI:1194959130
Name:CORONA, KAREN MICHELLE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:MICHELLE
Last Name:CORONA
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 1:8885 SW CANYON RD STE 135
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-3455
Mailing Address - Country:US
Mailing Address - Phone:925-222-1568
Mailing Address - Fax:
Practice Address - Street 1:8885 SW CANYON RD STE 135
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-3455
Practice Address - Country:US
Practice Address - Phone:925-222-1568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-05
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA250471041C0700X
ORL57191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical