MEDICARE: KAREN CONKLIN-JOHNSON 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	LPC-5484	CO

General Provider Information

NPI Number	:	1811229453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN CONKLIN-JOHNSON LPC

Provider Business Mailing Address
First Line	:	1556 WILLIAMS ST
Second Line	:	SUITE 202
City	:	DENVER
State	:	CO
Zip	:	80218-1661
Country	:	US
Telephone Number	:	303-909-9488
Fax Number	:

Provider Business Practice Location Address
First Line	:	1556 WILLIAMS ST
Second Line	:	SUITE 202
City	:	DENVER
State	:	CO
Zip	:	80218-1661
Country	:	US
Telephone Number	:	303-909-9488
Fax Number	:

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

Provider Enumeration Date	:	02/08/2010
Last Update Date	:	10/22/2010

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