Provider Demographics
NPI:1619276680
Name:HOUSTON, KAREN RENEE
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:RENEE
Last Name:HOUSTON
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 1:6584 HIGHBURY RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45424-3017
Mailing Address - Country:US
Mailing Address - Phone:937-559-9558
Mailing Address - Fax:
Practice Address - Street 1:813 TROY ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45404-1852
Practice Address - Country:US
Practice Address - Phone:937-982-5100
Practice Address - Fax:937-982-1600
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-16
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.339604163W00000X, 163WA0400X, 163WP0807X, 163WP0808X, 163WC0400X, 163WH0200X, 320600000X, 322D00000X, 385HR2055X, 385HR2060X
OH342000000X, 171M00000X, 172A00000X, 347E00000X
OHS.0701532104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No163W00000XNursing Service ProvidersRegistered Nurse
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No342000000XTransportation ServicesTransportation Network Company
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172A00000XOther Service ProvidersDriver
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No347E00000XTransportation ServicesTransportation Broker
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3141031Medicaid