Provider Demographics
NPI:1538719331
Name:JUSTICE, KAREN ASHTON (LCSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:ASHTON
Last Name:JUSTICE
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 1:8958 W. STATE ROAD 84
Mailing Address - Street 2:#1131
Mailing Address - City:FT. LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33324
Mailing Address - Country:US
Mailing Address - Phone:954-859-1049
Mailing Address - Fax:
Practice Address - Street 1:2250 PEMBROKE FALLS BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028
Practice Address - Country:US
Practice Address - Phone:954-859-1049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-13
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW129181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical