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General NPI Number Information
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NPI Number | 1750604120
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Entity Type | Individual
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Provider Name | KAREN SUE SEVERNS PSYD, LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/12/2010
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Last Update Date | 12/28/2021
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Provider Practice Location Address
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Address Line | 115 4TH AVE
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City | ABERDEEN
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State | SD
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Zip | 57401
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Country | US
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Telephone | 605-846-7193
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Fax | 208-686-5813
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Provider Business Mailing Address
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Address Line | 115 4TH AVE
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City | ABERDEEN
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State | SD
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Zip | 57401
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Country | US
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Telephone | 605-846-7193
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Fax | 208-686-5813
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW27799
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | X-10368
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C-10666
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License Number State | NM
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY32878
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License Number State | CA
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