Provider Demographics
NPI:1396300810
Name:COYNER, KAREN WARNER (LCSW, DCSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:WARNER
Last Name:COYNER
Suffix:
Gender:F
Credentials:LCSW, DCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14611 GILDENBOROUGH DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-6023
Mailing Address - Country:US
Mailing Address - Phone:804-318-7665
Mailing Address - Fax:
Practice Address - Street 1:10611 PATTERSON AVE
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23238-4733
Practice Address - Country:US
Practice Address - Phone:804-308-0118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-09
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040078871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty