Provider Demographics
NPI:1922767169
Name:FLEETWOOD, KAREN MICHELE (LPC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MICHELE
Last Name:FLEETWOOD
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 1:8428 OLD CAVALRY DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-4581
Mailing Address - Country:US
Mailing Address - Phone:804-994-7384
Mailing Address - Fax:
Practice Address - Street 1:9407 CUMBERLAND RD
Practice Address - Street 2:
Practice Address - City:NEW KENT
Practice Address - State:VA
Practice Address - Zip Code:23124-2029
Practice Address - Country:US
Practice Address - Phone:180-496-6176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701010600101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional