Healthcare Provider Details

I. General information

NPI: 1124770656
Provider Name (Legal Business Name): KAREN COREEN SHELDON LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2022
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E 9TH ST
DULUTH MN
55805-1604
US

IV. Provider business mailing address

220 RAILROAD ST SE
PINE CITY MN
55063-1540
US

V. Phone/Fax

Practice location:
  • Phone: 218-343-8847
  • Fax:
Mailing address:
  • Phone: 218-343-8847
  • Fax: 651-925-0071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3150
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: