Provider Demographics
NPI:1891964912
Name:DOUGLAS, KAREN MICHELLE (LICSW, LCSW-C)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:MICHELLE
Last Name:DOUGLAS
Suffix:
Gender:F
Credentials:LICSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 16TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-1401
Mailing Address - Country:US
Mailing Address - Phone:202-289-1510
Mailing Address - Fax:202-518-8924
Practice Address - Street 1:660 K ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3530
Practice Address - Country:US
Practice Address - Phone:202-698-4733
Practice Address - Fax:202-698-4727
Is Sole Proprietor?:No
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3026851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical