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General NPI Number Information
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NPI Number | 1457050783
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Entity Type | Individual
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Provider Name | KARISA JANAE LE LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/24/2023
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 510 E MAIN ST
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City | LITITZ
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State | PA
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Zip | 17543-2140
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Country | US
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Telephone | 717-405-0343
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Fax |
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Provider Business Mailing Address
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Address Line | 4 ROYAL DR
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City | LITITZ
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State | PA
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Zip | 17543-8218
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Country | US
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Telephone | 717-435-3967
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW023397
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License Number State | PA
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