Provider Demographics
NPI:1689663833
Name:PRATT, KAREN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:PRATT
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 1:1000 COMMERCIAL LN
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-8148
Mailing Address - Country:US
Mailing Address - Phone:757-942-1069
Mailing Address - Fax:
Practice Address - Street 1:1000 COMMERCIAL LN
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8148
Practice Address - Country:US
Practice Address - Phone:757-942-1069
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904000326101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAO88226OtherSENTARA FAMILY CARE
VA255595OtherMAMSI
VA8921032Medicaid
VA393247OtherHEALTHKEEPERS
VA4945310OtherVA PREMIER
VAS54718Medicare UPIN