MEDICARE: MISS KAREN LYNN SEYMOUR LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	C6236	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	2073782	OTHER	MS	MS BCBS

General Provider Information

NPI Number	:	1275637555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KAREN LYNN SEYMOUR LCSW

Provider Business Mailing Address
First Line	:	2555 RIVER PLACE BLVD
Second Line	:
City	:	BILOXI
State	:	MS
Zip	:	39531-2752
Country	:	US
Telephone Number	:	228-861-9877
Fax Number	:	228-594-9012

Provider Business Practice Location Address
First Line	:	1907 PASS ROAD SUITE G
Second Line	:
City	:	BILOXI
State	:	MS
Zip	:	39531-4101
Country	:	US
Telephone Number	:	228-861-9877
Fax Number	:	228-594-9012

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2006
Last Update Date	:	05/17/2024

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