Provider Demographics
NPI:1316422645
Name:SMITH, KAREN
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8352 LAFITTE CT
Mailing Address - Street 2:STE A
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043-4321
Mailing Address - Country:US
Mailing Address - Phone:504-432-8598
Mailing Address - Fax:833-903-0140
Practice Address - Street 1:8352 LAFITTE CT
Practice Address - Street 2:STE A
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-4321
Practice Address - Country:US
Practice Address - Phone:504-432-8598
Practice Address - Fax:833-903-0140
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-02
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA104100000X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty