Basic Information
Provider Information
NPI: 1003804683
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BINDER
FirstName: KAREN
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: LICSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 24 IRELAND RD
Address2:  
City: NEWTON CENTRE
State: MA
PostalCode: 024591268
CountryCode: US
TelephoneNumber: 6172448389
FaxNumber: 7814385553
Practice Location
Address1: 271 MAIN ST
Address2: SUITE 205
City: STONEHAM
State: MA
PostalCode: 021803591
CountryCode: US
TelephoneNumber: 6172448389
FaxNumber: 7814385553
Other Information
ProviderEnumerationDate: 10/08/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X104801MAY Behavioral Health & Social Service ProvidersCounselorMental Health

ID Information
IDTypeStateIssuerDescription
185415105MA MEDICAID


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