Healthcare Provider Details

I. General information

NPI: 1528053394
Provider Name (Legal Business Name): KAREN H HAWORTH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8333 N DAVIS HWY 11TH FLOOR
PENSACOLA FL
32514-6050
US

IV. Provider business mailing address

8333 N DAVIS HWY 11TH FLOOR
PENSACOLA FL
32514-6050
US

V. Phone/Fax

Practice location:
  • Phone: 850-474-8360
  • Fax: 850-969-2970
Mailing address:
  • Phone: 850-474-8360
  • Fax: 850-969-2970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW2031
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: