Provider Demographics
NPI:1992985642
Name:GOOZH, KAREN R (KAREN R GOOZH,LCSWC)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:R
Last Name:GOOZH
Suffix:
Gender:F
Credentials:KAREN R GOOZH,LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10917 ROUNDTABLE COURT
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2085
Mailing Address - Country:US
Mailing Address - Phone:301-656-8122
Mailing Address - Fax:301-493-6647
Practice Address - Street 1:10917 ROUNDTABLE CT
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4558
Practice Address - Country:US
Practice Address - Phone:301-656-8122
Practice Address - Fax:301-493-6647
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-10
Last Update Date:2007-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08497104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD624370Medicare PIN