MEDICARE: MRS. KATHLEEN JO KARNOFF ABD

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	101YP2500X	Professional Counselor	PC004933	PA

General Provider Information

NPI Number	:	1740515733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHLEEN JO KARNOFF ABD

Provider Business Mailing Address
First Line	:	1150 CAPOUSE AVE.
Second Line	:
City	:	SCRANTON
State	:	PA
Zip	:	18509
Country	:	US
Telephone Number	:	570-586-6020
Fax Number	:	570-585-1866

Provider Business Practice Location Address
First Line	:	120 NORTH ABINGTON ROAD
Second Line	:	LOWER LEVEL
City	:	CLARKS SUMMIT
State	:	PA
Zip	:	18411-2023
Country	:	US
Telephone Number	:	570-586-6020
Fax Number	:	570-585-1866

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

Provider Enumeration Date	:	10/08/2009
Last Update Date	:	10/08/2009

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