Provider Demographics
NPI:1043606858
Name:KAREN MARULLO MA,LPC
Entity Type:Organization
Organization Name:KAREN MARULLO MA,LPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:GOLDMAN
Authorized Official - Last Name:MARULLO
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:205-823-2373
Mailing Address - Street 1:400 VESTAVIA PKWY STE 130
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35216-3750
Mailing Address - Country:US
Mailing Address - Phone:205-823-2373
Mailing Address - Fax:
Practice Address - Street 1:400 VESTAVIA PKWY STE 130
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35216-3750
Practice Address - Country:US
Practice Address - Phone:205-823-2373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-08
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1555101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty