Provider Demographics
NPI:1871542266
Name:HUBBARD, KAREN SUE (LBSW)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:SUE
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 HEATHWOOD PL
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-8991
Mailing Address - Country:US
Mailing Address - Phone:864-557-2911
Mailing Address - Fax:864-850-3017
Practice Address - Street 1:215 HEATHWOOD PL
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-8991
Practice Address - Country:US
Practice Address - Phone:864-557-2911
Practice Address - Fax:864-850-3017
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5345104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX0486Medicaid