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General NPI Number Information
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NPI Number | 1376286799
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Entity Type | Individual
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Provider Name | KAREN DANIELLE RUBIN-FORTIER LPC
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Gender | Female
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Dates
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Enumeration Date | 04/14/2022
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 12452 STAFFORD ST STE A
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City | RAVENNA
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State | MI
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Zip | 49451-5103
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Country | US
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Telephone | 231-798-5220
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Fax |
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Provider Business Mailing Address
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Address Line | 4664 MAPLE ST
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City | NORTON SHORES
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State | MI
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Zip | 49441-5341
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Country | US
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Telephone | 616-402-5516
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6451022594
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License Number State | MI
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