Provider Demographics
NPI:1316128523
Name:PHILLIPS, KARIAH C (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:KARIAH
Middle Name:C
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 REGENTS BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:FIRCREST
Mailing Address - State:WA
Mailing Address - Zip Code:98466-6089
Mailing Address - Country:US
Mailing Address - Phone:253-238-6554
Mailing Address - Fax:253-590-0821
Practice Address - Street 1:1033 REGENTS BLVD
Practice Address - Street 2:STE 101
Practice Address - City:FIRCREST
Practice Address - State:WA
Practice Address - Zip Code:98466-6089
Practice Address - Country:US
Practice Address - Phone:253-238-6554
Practice Address - Fax:253-590-0821
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW602003131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical