Provider Demographics
NPI:1346373644
Name:UNDERWOOD, KAREN MICHELLE (LCMHC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MICHELLE
Last Name:UNDERWOOD
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:MICHELLE
Other - Last Name:HANCOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:315 GOOSE ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY LOG
Mailing Address - State:GA
Mailing Address - Zip Code:30522-2515
Mailing Address - Country:US
Mailing Address - Phone:706-273-6512
Mailing Address - Fax:
Practice Address - Street 1:91 TIMBERLANE RD
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-7927
Practice Address - Country:US
Practice Address - Phone:828-586-5501
Practice Address - Fax:828-837-7468
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6880101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional