Provider Demographics
NPI:1306996046
Name:BERKOWITZ, KAREN S (PHD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:S
Last Name:BERKOWITZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 WURZBACH RD
Mailing Address - Street 2:SUITE 1204
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-4330
Mailing Address - Country:US
Mailing Address - Phone:210-614-9337
Mailing Address - Fax:210-614-9339
Practice Address - Street 1:8600 WURZBACH RD
Practice Address - Street 2:SUITE 1204
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-4330
Practice Address - Country:US
Practice Address - Phone:210-614-9337
Practice Address - Fax:210-614-9339
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22194103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0357154-01Medicaid
TX8F22118Medicare PIN