Provider Demographics
NPI:1275637555
Name:SEYMOUR, KAREN LYNN (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:KAREN
Middle Name:LYNN
Last Name:SEYMOUR
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 1:925 TOMMY MUNRO DR
Mailing Address - Street 2:SUITE F1
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-2134
Mailing Address - Country:US
Mailing Address - Phone:228-388-9877
Mailing Address - Fax:228-388-9877
Practice Address - Street 1:925 TOMMY MUNRO DR
Practice Address - Street 2:SUITE F1
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-2134
Practice Address - Country:US
Practice Address - Phone:228-388-9877
Practice Address - Fax:228-388-9877
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC62361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00124857Medicaid
MS00124857Medicaid