Basic Information
Provider Information
NPI: 1124130786
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AMSPACHER
FirstName: KAREN
MiddleName: GROH
NamePrefix: MRS.
NameSuffix:  
Credential: MSS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6 RAYMOND CIR
Address2:  
City: DOWNINGTOWN
State: PA
PostalCode: 193351314
CountryCode: US
TelephoneNumber: 6108730311
FaxNumber:  
Practice Location
Address1: 1400 BLACKHORSE HILL RD
Address2: 8-B
City: COATESVILLE
State: PA
PostalCode: 193202040
CountryCode: US
TelephoneNumber: 6103847711
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/31/2006
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
1041C0700XSW004540EPAY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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