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General NPI Number Information
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NPI Number | 1871976431
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Entity Type | Individual
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Provider Name | MARY ELIZABETH KARLAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/01/2015
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Last Update Date | 10/22/2020
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Provider Practice Location Address
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Address Line | 177 SOUND BEACH AVE STE 6
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City | OLD GREENWICH
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State | CT
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Zip | 06870-1740
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Country | US
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Telephone | 203-493-0937
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Fax |
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Provider Business Mailing Address
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Address Line | 177 SOUND BEACH AVE STE 6
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City | OLD GREENWICH
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State | CT
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Zip | 06870-1740
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Country | US
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Telephone | 203-493-0937
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 088338-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 121299
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License Number State |
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 001369
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License Number State | CT
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