Healthcare Provider Details

I. General information

NPI: 1275637555
Provider Name (Legal Business Name): KAREN LYNN SEYMOUR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2006
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1907 PASS ROAD SUITE G
BILOXI MS
39531-4101
US

IV. Provider business mailing address

2555 RIVER PLACE BLVD
BILOXI MS
39531-2752
US

V. Phone/Fax

Practice location:
  • Phone: 228-861-9877
  • Fax: 228-594-9012
Mailing address:
  • Phone: 228-861-9877
  • Fax: 228-594-9012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC6236
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: