Provider Demographics
NPI:1487306825
Name:STENSTROM, KAREN MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:STENSTROM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 637273
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-7273
Mailing Address - Country:US
Mailing Address - Phone:812-842-4200
Mailing Address - Fax:
Practice Address - Street 1:7409 EAGLE CREST BLVD STE G
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-9136
Practice Address - Country:US
Practice Address - Phone:812-842-4020
Practice Address - Fax:812-842-4019
Is Sole Proprietor?:No
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004100A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN34004100AOtherIN STATE LICENSE