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NPI Code Detail

MEDICARE: KARLA WHITLOCK MA, LPC

MEDICARE:   KARLA  WHITLOCK  MA, LPC
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
1101YP2500XProfessional CounselorC4229OR

General Provider Information

NPI Number : 1659504819
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARLA WHITLOCK MA, LPC
Provider Business Mailing Address
First Line : PO BOX 1121
Second Line :
City : ROSEBURG
State : OR
Zip : 97470-0254
Country : US
Telephone Number : 541-672-2691
Fax Number :
Provider Business Practice Location Address
First Line : 548 SE JACKSON ST
Second Line :
City : ROSEBURG
State : OR
Zip : 97470-4983
Country : US
Telephone Number : 541-229-8934
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2009
Last Update Date : 09/13/2023

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Directions to “ KARLA WHITLOCK MA, LPC” Practice Location

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