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General NPI Number Information
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NPI Number | 1164946190
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Entity Type | Organization
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Legal Business Name | KAREN COUNSELING ASSOCIATES
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Dates
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Enumeration Date | 08/01/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 221 S. METTER AVE
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City | COLUMBIA
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State | IL
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Zip | 62236-2253
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Country | US
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Telephone | 618-281-9282
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Fax | 888-972-9396
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Provider Business Mailing Address
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Address Line | 221 S METTER AVE
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City | COLUMBIA
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State | IL
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Zip | 62236-2253
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Country | US
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Telephone | 618-281-9282
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Fax | 888-972-9396
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KAREN S LUNDY
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Credential | LCPC
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Telephone | 618-281-9282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 180.010771
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 180.004562
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License Number State | IL
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