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:PO BOX 792
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:LA
Mailing Address - Zip Code:71221-0792
Mailing Address - Country:US
Mailing Address - Phone:318-283-8887
Mailing Address - Fax:318-281-2559
Practice Address - Street 1:501 DURHAM ST
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:LA
Practice Address - Zip Code:71220-5012
Practice Address - Country:US
Practice Address - Phone:318-556-8440
Practice Address - Fax:318-556-8449
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-03
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7440101YA0400X, 101YP2500X, 101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor