Provider Demographics
NPI:1336614569
Name:UNDERWOOD, KAREN LAJUNE (PHD, LPC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LAJUNE
Last Name:UNDERWOOD
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:LAJUNE
Other - Last Name:UNDERWOOD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3704 COLISEUM BLVD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3625
Mailing Address - Country:US
Mailing Address - Phone:318-442-8026
Mailing Address - Fax:
Practice Address - Street 1:3704 COLISEUM BLVD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3625
Practice Address - Country:US
Practice Address - Phone:318-442-8026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-03
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7440101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional