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General NPI Number Information
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NPI Number | 1487936498
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Entity Type | Individual
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Provider Name | KAREN L BAILEY ADDISON LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/15/2011
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Last Update Date | 09/15/2011
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Provider Practice Location Address
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Address Line | 1229 ALBANY AVE STE 4
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City | HARTFORD
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State | CT
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Zip | 06112-2156
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Country | US
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Telephone | 860-293-1000
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Fax | 860-293-1031
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Provider Business Mailing Address
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Address Line | 80 COVENTRY ST
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City | HARTFORD
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State | CT
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Zip | 06112-1519
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Country | US
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Telephone | 860-371-4549
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Fax | 860-493-0756
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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 | 001666
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License Number State | CT
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