Provider Demographics
NPI:1942492954
Name:MCDERMOTT, KARLA (LMSW)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KARLA
Other - Middle Name:
Other - Last Name:BEAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:22214 D. STREET
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156
Mailing Address - Country:US
Mailing Address - Phone:620-442-4540
Mailing Address - Fax:620-442-4559
Practice Address - Street 1:22214 D. STREET
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156
Practice Address - Country:US
Practice Address - Phone:620-442-4540
Practice Address - Fax:620-442-4559
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6957104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker