Provider Demographics
NPI:1295982551
Name:REISS, KAREN J (LCSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:J
Last Name:REISS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 LAKE WARREN RD
Mailing Address - Street 2:
Mailing Address - City:UPPER BLACK EDDY
Mailing Address - State:PA
Mailing Address - Zip Code:18972-9621
Mailing Address - Country:US
Mailing Address - Phone:267-424-5666
Mailing Address - Fax:
Practice Address - Street 1:260 LAKE WARREN RD
Practice Address - Street 2:
Practice Address - City:UPPER BLACK EDDY
Practice Address - State:PA
Practice Address - Zip Code:18972-9621
Practice Address - Country:US
Practice Address - Phone:267-424-5666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0237981041C0700X
PASW126235104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker