Provider Demographics
NPI:1477786184
Name:STROUP, KARLY (PSYD, ABPP)
Entity Type:Individual
Prefix:DR
First Name:KARLY
Middle Name:
Last Name:STROUP
Suffix:
Gender:F
Credentials:PSYD, ABPP
Other - Prefix:DR
Other - First Name:KARLY
Other - Middle Name:
Other - Last Name:WARREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD, ABPP
Mailing Address - Street 1:201 MCNULTY ST
Mailing Address - Street 2:
Mailing Address - City:BLYTHEWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29016-8554
Mailing Address - Country:US
Mailing Address - Phone:330-519-1788
Mailing Address - Fax:
Practice Address - Street 1:201 MCNULTY ST
Practice Address - Street 2:
Practice Address - City:BLYTHEWOOD
Practice Address - State:SC
Practice Address - Zip Code:29016-8554
Practice Address - Country:US
Practice Address - Phone:330-519-1788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-27
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1301103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical