Provider Demographics
NPI:1255610820
Name:ALLEN, KAREN LOIS (KAREN ALLEN)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LOIS
Last Name:ALLEN
Suffix:
Gender:F
Credentials:KAREN ALLEN
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:LOIS
Other - Last Name:ALLEN-PEART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:4329 NORTHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-2601
Mailing Address - Country:US
Mailing Address - Phone:301-741-7934
Mailing Address - Fax:
Practice Address - Street 1:4329 NORTHVIEW DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-2601
Practice Address - Country:US
Practice Address - Phone:301-741-7934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-12
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13920101YM0800X
DCLC303304101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0667358Medicaid
MD236850Y3MMedicare PIN