Provider Demographics
NPI:1457050783
Name:LE, KARISA JANAE (LCSW)
Entity type:Individual
Prefix:
First Name:KARISA
Middle Name:JANAE
Last Name:LE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KARISA
Other - Middle Name:JANAE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:4 ROYAL DR
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-8218
Mailing Address - Country:US
Mailing Address - Phone:717-435-3967
Mailing Address - Fax:
Practice Address - Street 1:510 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-2140
Practice Address - Country:US
Practice Address - Phone:717-405-0343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-24
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0233971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical