Provider Demographics
NPI:1538161575
Name:BRANDON, KAREN (LSW)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:BRANDON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 W POMFRET ST
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-3217
Mailing Address - Country:US
Mailing Address - Phone:717-258-0214
Mailing Address - Fax:717-258-3158
Practice Address - Street 1:47 W POMFRET ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-3217
Practice Address - Country:US
Practice Address - Phone:717-258-0214
Practice Address - Fax:717-258-3158
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA012135101YM0800X, 101YP1600X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA124530OtherVALUE OPTIONS
PA222910OtherCOMPSYCH
PA485274000OtherMAGELLAN
PA810554001OtherAETNA
PA810554001OtherTRICARE
PA1617024OtherFEDERAL HIGHMARK BS
PA810554001OtherTEAM EAP
PA810554001OtherTEAMSTERS
PA50026345OtherCAPITAL BLUE CROSS
PA810554001OtherPACIFICARE
PA810554001OtherHEALTHNET TRICARE
PA1011538850001OtherDEPT. OF PUBLIC WELFARE
PA8001959469OtherCOMMUNITY BEH.MENTAL HLTH
PA810554001OtherQUEST
PA810554001OtherTEAM EAP