Provider Demographics
NPI:1831141464
Name:KARRIEM, KHADIJAH NMN (LPC)
Entity Type:Individual
Prefix:MS
First Name:KHADIJAH
Middle Name:NMN
Last Name:KARRIEM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1842 FERNCREEK PL
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-6279
Mailing Address - Country:US
Mailing Address - Phone:804-874-1842
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:1842 FERNCREEK PL
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-6279
Practice Address - Country:US
Practice Address - Phone:804-874-1842
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002965101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional