MEDICARE: MS. KAREN B. POPSON 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	PR028837-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	139897FK	OTHER	NY	PREFERRED CARE
2	6206161	OTHER	NM	INDEPENDENT HEALTH
3	027426	OTHER	NY	VALUE OPTIONS WESTINGHOUS
4	511165001	OTHER	NY	BLUE CROSS BLUE SHIELD
5	7499972	OTHER	NY	VALUE OPTIONS EMPIRE GHI
6	00020966301	OTHER	NY	UNIVERA

General Provider Information

NPI Number	:	1689739104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAREN B. POPSON LCSW

Provider Business Mailing Address
First Line	:	265 UNION ST
Second Line	:	SUITE 104
City	:	HAMBURG
State	:	NY
Zip	:	14075-4752
Country	:	US
Telephone Number	:	716-648-5262
Fax Number	:	716-648-1033

Provider Business Practice Location Address
First Line	:	265 UNION ST
Second Line	:	SUITE 104
City	:	HAMBURG
State	:	NY
Zip	:	14075-4752
Country	:	US
Telephone Number	:	716-648-5262
Fax Number	:	716-648-1033

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

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	06/14/2014

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