MEDICARE: KAREN W. NOLEN LICSW

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	114633	MA

General Provider Information

NPI Number	:	1902046030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN W. NOLEN LICSW

Provider Business Mailing Address
First Line	:	PO BOX 625
Second Line	:
City	:	NORTHAMPTON
State	:	MA
Zip	:	01061-0625
Country	:	US
Telephone Number	:	413-658-7514
Fax Number	:	413-397-3366

Provider Business Practice Location Address
First Line	:	110 N HILLSIDE RD STE 3
Second Line	:
City	:	SOUTH DEERFIELD
State	:	MA
Zip	:	01373-9727
Country	:	US
Telephone Number	:	413-658-7514
Fax Number	:	413-397-3366

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

Provider Enumeration Date	:	03/03/2009
Last Update Date	:	12/23/2011

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