Provider Demographics
NPI:1174998777
Name:CONLON, KAREN JACKELINE (LCSW)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:JACKELINE
Last Name:CONLON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 E 54TH ST RM 84
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-9205
Mailing Address - Country:US
Mailing Address - Phone:347-704-0632
Mailing Address - Fax:
Practice Address - Street 1:59 E 54TH ST RM 84
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-9205
Practice Address - Country:US
Practice Address - Phone:347-704-0632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-08
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY087803101YM0800X
NY096414104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health