Basic Information
| Provider Information | |||||||||
| NPI: | 1013954627 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RICHMOND | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | O | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | PARSONS | ||||||||
| OtherFirstName: | KAREN | ||||||||
| OtherMiddleName: | O | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | LCSW | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 138 S. MAIN | ||||||||
| Address2: | |||||||||
| City: | AFTON | ||||||||
| State: | OK | ||||||||
| PostalCode: | 743318927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9182574244 | ||||||||
| FaxNumber: | 9182574247 | ||||||||
| Practice Location | |||||||||
| Address1: | 138 S MAIN | ||||||||
| Address2: | |||||||||
| City: | AFTON | ||||||||
| State: | OK | ||||||||
| PostalCode: | 743318927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9182574244 | ||||||||
| FaxNumber: | 9182574247 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2006 | ||||||||
| LastUpdateDate: | 06/23/2011 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialNameSuffix: | |||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 2607 | OK | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.