Provider Demographics
NPI:1750604120
Name:SEVERNS, KAREN SUE (PSYD, LCSW)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:SUE
Last Name:SEVERNS
Suffix:
Gender:F
Credentials:PSYD, LCSW
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:SUE
Other - Last Name:VASSAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:115 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401
Mailing Address - Country:US
Mailing Address - Phone:605-846-7193
Mailing Address - Fax:208-686-5813
Practice Address - Street 1:115 4TH AVE
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401
Practice Address - Country:US
Practice Address - Phone:605-846-7193
Practice Address - Fax:208-686-5813
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-12
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW277991041C0700X
NMX-103681041C0700X
NMC-106661041C0700X
CAPSY32878103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical