Provider Demographics
NPI:1427182468
Name:CHADWICK, KAREN LYNN (MFT-I)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LYNN
Last Name:CHADWICK
Suffix:
Gender:F
Credentials:MFT-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 SCOTT ST APT 2
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-3233
Mailing Address - Country:US
Mailing Address - Phone:415-621-8900
Mailing Address - Fax:
Practice Address - Street 1:1885 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-3501
Practice Address - Country:US
Practice Address - Phone:415-934-3467
Practice Address - Fax:415-861-5886
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF46639106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist