MEDICARE: MS. KAREN DEE LOMBARDI LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW19321	AZ

General Provider Information

NPI Number	:	1174523252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAREN DEE LOMBARDI LCSW

Provider Business Mailing Address
First Line	:	PO BOX 1304
Second Line	:
City	:	ORACLE
State	:	AZ
Zip	:	85623-1304
Country	:	US
Telephone Number	:	520-896-9470
Fax Number	:	520-896-9470

Provider Business Practice Location Address
First Line	:	381 EAST AMERICAN AVE
Second Line	:
City	:	ORACLE
State	:	AZ
Zip	:	85623
Country	:	US
Telephone Number	:	520-955-0414
Fax Number	:	520-896-9470

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	05/27/2010

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