Provider Demographics
NPI:1083006191
Name:DUKE, KARLA JEAN (EDS LPC/MHSP)
Entity Type:Individual
Prefix:MS
First Name:KARLA
Middle Name:JEAN
Last Name:DUKE
Suffix:
Gender:F
Credentials:EDS LPC/MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2685
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38502-2685
Mailing Address - Country:US
Mailing Address - Phone:931-303-7789
Mailing Address - Fax:931-520-0767
Practice Address - Street 1:441 E BROAD ST
Practice Address - Street 2:SUITE B
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3389
Practice Address - Country:US
Practice Address - Phone:931-303-7789
Practice Address - Fax:931-520-0767
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-26
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000003193101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional