Healthcare Provider Details

I. General information

NPI: 1295982551
Provider Name (Legal Business Name): KAREN J REISS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 LAKE WARREN RD
UPPER BLACK EDDY PA
18972-9621
US

IV. Provider business mailing address

260 LAKE WARREN RD
UPPER BLACK EDDY PA
18972-9621
US

V. Phone/Fax

Practice location:
  • Phone: 267-424-5666
  • Fax:
Mailing address:
  • Phone: 267-424-5666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW023798
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW126235
License Number StatePA

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: