Provider Demographics
NPI:1619652237
Name:MCLEOD, KAREN BURDETTE (LCSWA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:BURDETTE
Last Name:MCLEOD
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 W ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-8201
Mailing Address - Country:US
Mailing Address - Phone:910-495-4479
Mailing Address - Fax:
Practice Address - Street 1:817 W ACADEMY ST
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-8201
Practice Address - Country:US
Practice Address - Phone:910-495-4479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0185651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical