Healthcare Provider Details

I. General information

NPI: 1285026708
Provider Name (Legal Business Name): KAREN KAY ISAACS CHW/CRS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2015
Last Update Date: 02/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 W 21ST ST
CONNERSVILLE IN
47331-2930
US

IV. Provider business mailing address

1514 CONWELL STREET 208 WST 21ST STREET
CONNERSVILLE INDIANA
47331
UM

V. Phone/Fax

Practice location:
  • Phone: 765-338-9885
  • Fax: 765-222-1249
Mailing address:
  • Phone: 765-338-9885
  • Fax: 765-222-1249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: