Provider Demographics
NPI:1124587266
Name:DEAN-METTLING, KARLA JEAN (LCSW)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:JEAN
Last Name:DEAN-METTLING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KARLA
Other - Middle Name:JEAN
Other - Last Name:METTLING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:7428 SILVER PINE DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22153-1820
Mailing Address - Country:US
Mailing Address - Phone:571-244-1557
Mailing Address - Fax:
Practice Address - Street 1:5276 LYNGATE CT
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-1688
Practice Address - Country:US
Practice Address - Phone:571-244-1557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040109581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical