MEDICARE: KARLI ANN DOUGHTY 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
1	101YP2500X	Professional Counselor	11696-125	WI
2	101YP2500X	Professional Counselor	7649226	WI

General Provider Information

NPI Number	:	1740062108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLI ANN DOUGHTY LPC

Provider Business Mailing Address
First Line	:	1200 RIVER VIEW AVE APT 1
Second Line	:
City	:	STEVENS POINT
State	:	WI
Zip	:	54481-5131
Country	:	US
Telephone Number	:	715-482-0465
Fax Number	:

Provider Business Practice Location Address
First Line	:	2417 POST RD
Second Line	:
City	:	STEVENS POINT
State	:	WI
Zip	:	54481-6134
Country	:	US
Telephone Number	:	715-842-9500
Fax Number	:

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

Provider Enumeration Date	:	10/19/2023
Last Update Date	:	04/06/2025

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