Provider Demographics
NPI:1265753198
Name:LOCKARD, KAREN FAIRCLOTH (LCSW)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:FAIRCLOTH
Last Name:LOCKARD
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 1:216 LAKE ELLA DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-5545
Mailing Address - Country:US
Mailing Address - Phone:850-841-7733
Mailing Address - Fax:850-841-7702
Practice Address - Street 1:216 LAKE ELLA DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-5545
Practice Address - Country:US
Practice Address - Phone:850-841-7733
Practice Address - Fax:850-841-7702
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 56921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical