Provider Demographics
NPI:1699383133
Name:STORY, KARMEN (LCSW, CSOTP)
Entity Type:Individual
Prefix:
First Name:KARMEN
Middle Name:
Last Name:STORY
Suffix:
Gender:F
Credentials:LCSW, CSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4190 CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-4681
Mailing Address - Country:US
Mailing Address - Phone:757-642-7525
Mailing Address - Fax:
Practice Address - Street 1:501 N 2ND ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-1359
Practice Address - Country:US
Practice Address - Phone:757-642-7525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040103091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical