Provider Demographics
NPI:1861700726
Name:JENNINGS, KAREN A (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:A
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 SCHOOL ST
Mailing Address - Street 2:MSAD
Mailing Address - City:NO. BERWICK
Mailing Address - State:ME
Mailing Address - Zip Code:03901
Mailing Address - Country:US
Mailing Address - Phone:207-676-2234
Mailing Address - Fax:
Practice Address - Street 1:20 BLACKBERRY HILL RD
Practice Address - Street 2:
Practice Address - City:BERWICK
Practice Address - State:ME
Practice Address - Zip Code:03901-2707
Practice Address - Country:US
Practice Address - Phone:207-698-4465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC56411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical