| Karla Drake Lcsw Llc | |
|
317 Office Square Ln Ste B101 Virginia Beach VA 23462-3650 | |
| (757) 642-4170 | |
| Not Available |
| Full Name | Karla Drake Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 317 Office Square Ln, Virginia Beach, Virginia |
| Authorized Official Name and Position | Karla Drake (OWNER) |
| Authorized Official Contact | 7576424170 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Karla Drake Lcsw Llc 5549 Westward Dr Virginia Beach VA 23464-4042 Ph: (757) 642-4170 | Karla Drake Lcsw Llc 317 Office Square Ln Ste B101 Virginia Beach VA 23462-3650 Ph: (757) 642-4170 |
| NPI Number | 1457705287 |
|---|---|
| Provider Enumeration Date | 04/18/2016 |
| Last Update Date | 04/18/2016 |
| Medicare PECOS PAC ID | 1850690884 |
|---|---|
| Medicare Enrollment ID | O20160426001385 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457705287 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0904006100 (Virginia) | Primary |
| Provider Name | Karla Kay Drake |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134184302 PECOS PAC ID: 8921102930 Enrollment ID: I20070402000144 |
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