Healthcare Provider Details

I. General information

NPI: 1346544186
Provider Name (Legal Business Name): KAREN WOODBURY L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN LYNN HARMON

II. Dates (important events)

Enumeration Date: 01/10/2011
Last Update Date: 01/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 S 10TH ST
SAINT JOSEPH MO
64503-2405
US

IV. Provider business mailing address

2303 VILLAGE DR
SAINT JOSEPH MO
64506-4954
US

V. Phone/Fax

Practice location:
  • Phone: 816-233-5188
  • Fax: 816-232-2696
Mailing address:
  • Phone: 816-271-8219
  • Fax: 816-232-2696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number002661
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: