Provider Demographics
NPI:1790811040
Name:NEYMARK, KAREN Z (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:Z
Last Name:NEYMARK
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 1:319 EDWIN DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-4541
Mailing Address - Country:US
Mailing Address - Phone:757-497-9545
Mailing Address - Fax:757-497-8192
Practice Address - Street 1:319 EDWIN DR
Practice Address - Street 2:SUITE 103
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-4541
Practice Address - Country:US
Practice Address - Phone:757-497-9545
Practice Address - Fax:757-497-8192
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040002671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA8907404Medicaid
0298038OtherANTHEM