MEDICARE: KAREN LYNN TINSLEY LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCS19757	CA

General Provider Information

NPI Number	:	1104997246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN LYNN TINSLEY LCSW

Provider Business Mailing Address
First Line	:	PO BOX 60391
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91116
Country	:	US
Telephone Number	:	310-922-0044
Fax Number	:

Provider Business Practice Location Address
First Line	:	446 S MARENGO AVE
Second Line	:	STE A
City	:	PASADENA
State	:	CA
Zip	:	91101-3113
Country	:	US
Telephone Number	:	310-922-0044
Fax Number	:	626-628-3277

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2006
Last Update Date	:	02/16/2017

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