Provider Demographics
NPI:1093168841
Name:KAREN L. MCKOWN LCSW LLC
Entity Type:Organization
Organization Name:KAREN L. MCKOWN LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:MCKOWN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:757-619-9279
Mailing Address - Street 1:373 GAINSBOROUGH RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-4122
Mailing Address - Country:US
Mailing Address - Phone:757-619-9279
Mailing Address - Fax:757-228-5291
Practice Address - Street 1:317 OFFICE SQUARE LN
Practice Address - Street 2:SUITE 101B
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3650
Practice Address - Country:US
Practice Address - Phone:757-619-9279
Practice Address - Fax:757-228-5291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040056171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty