Provider Demographics
NPI:1386103711
Name:LANDRUM, KAREN STEVENSON (LCSW)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:STEVENSON
Last Name:LANDRUM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:ANNE
Other - Last Name:STEVENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:14051 ST FRANCIS BLVD STE 2200
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-3203
Mailing Address - Country:US
Mailing Address - Phone:804-310-4013
Mailing Address - Fax:
Practice Address - Street 1:14051 ST FRANCIS BLVD STE 2200
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-3203
Practice Address - Country:US
Practice Address - Phone:804-310-4013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-15
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040048821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical