Provider Demographics
NPI:1104136183
Name:LAWRENCE, KARLA (LCPC, BC-TMH)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:LCPC, BC-TMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 334
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20741-0334
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5557 BALTIMORE AVE STE 500-1026
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20781-1922
Practice Address - Country:US
Practice Address - Phone:240-257-2787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-08
Last Update Date:2019-09-15
Deactivation Date:2018-04-04
Deactivation Code:
Reactivation Date:2019-08-09
Provider Licenses
StateLicense IDTaxonomies
MDLC3668101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional