Provider Demographics
NPI:1730591314
Name:WARE, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:WARE
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:PO BOX 1982
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:GA
Mailing Address - Zip Code:30467-7182
Mailing Address - Country:US
Mailing Address - Phone:912-536-5418
Mailing Address - Fax:
Practice Address - Street 1:215 INDUSTRIAL RD
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:GA
Practice Address - Zip Code:30467-1866
Practice Address - Country:US
Practice Address - Phone:912-209-5941
Practice Address - Fax:912-567-3600
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-29
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007606101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional