Provider Demographics
NPI:1215244124
Name:GLASS, KAREN SIEGEL (LCSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:SIEGEL
Last Name:GLASS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:RACHEL
Other - Last Name:SIEGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5101 DOUGLAS FIR RD
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1440
Mailing Address - Country:US
Mailing Address - Phone:818-515-7207
Mailing Address - Fax:
Practice Address - Street 1:5101 DOUGLAS FIR RD
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1440
Practice Address - Country:US
Practice Address - Phone:818-515-7207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2023-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0844881041C0700X
CALCSW1181711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical