Healthcare Provider Details

I. General information

NPI: 1467681478
Provider Name (Legal Business Name): KAREN M. G. PAGURA L.I.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2009
Last Update Date: 07/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 LANTERN LN
PLAIN CITY OH
43064-2127
US

IV. Provider business mailing address

365 LANTERN LN
PLAIN CITY OH
43064-2127
US

V. Phone/Fax

Practice location:
  • Phone: 614-873-3137
  • Fax:
Mailing address:
  • Phone: 614-873-3137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI0004890
License Number StateOH

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: