Provider Demographics
NPI:1093702581
Name:HASBROUCK, KAREN E (LCSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:E
Last Name:HASBROUCK
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 1:2006 BREMO RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2438
Mailing Address - Country:US
Mailing Address - Phone:804-288-1881
Mailing Address - Fax:804-282-6413
Practice Address - Street 1:2006 BREMO RD
Practice Address - Street 2:SUITE 101
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2438
Practice Address - Country:US
Practice Address - Phone:804-288-1881
Practice Address - Fax:804-282-6413
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040049341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009999841Medicaid
7530514OtherAETNA
228773OtherCOMPSYCH
55729000OtherMAGELLAN
301263OtherANTHEM HEALTHKEEPERS
861112647OtherUBH
0803313MOtherOPTIMA
289387OtherANTHEM
2222943OtherCIGNA
2222943OtherCIGNA