Provider Demographics
NPI:1114355179
Name:ANDERSON, KARIMA (LCSW)
Entity type:Individual
Prefix:
First Name:KARIMA
Middle Name:
Last Name:ANDERSON
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 1:459 GRACE AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-2756
Mailing Address - Country:US
Mailing Address - Phone:850-215-6007
Mailing Address - Fax:850-215-6003
Practice Address - Street 1:1713 MAHAN DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-1218
Practice Address - Country:US
Practice Address - Phone:850-681-6001
Practice Address - Fax:850-681-6003
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-29
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW147291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical