Healthcare Provider Details

I. General information

NPI: 1770856544
Provider Name (Legal Business Name): KAREN POSSESSKY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2012
Last Update Date: 02/07/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 HOULTON ST
PATTEN ME
04765-3035
US

IV. Provider business mailing address

5612 SMU BLVD SUITE 208
DALLAS TX
75206-5098
US

V. Phone/Fax

Practice location:
  • Phone: 207-538-3700
  • Fax:
Mailing address:
  • Phone: 972-971-5279
  • Fax: 214-810-7076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number51036
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC22014
License Number StateME

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: