Provider Demographics
NPI:1992291397
Name:CHACE, KARINA M (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:KARINA
Middle Name:M
Last Name:CHACE
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:DR
Other - First Name:KARINA
Other - Middle Name:M
Other - Last Name:CHACE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:36416 SILCOTT MEADOW PL
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-3970
Mailing Address - Country:US
Mailing Address - Phone:503-752-1388
Mailing Address - Fax:
Practice Address - Street 1:133 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-3175
Practice Address - Country:US
Practice Address - Phone:503-752-1388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-09
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007353101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional