Provider Demographics
NPI:1083053433
Name:DEGRAAF, KAREN (LPC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:DEGRAAF
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 YAMASEE RD
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-8982
Mailing Address - Country:US
Mailing Address - Phone:704-681-5618
Mailing Address - Fax:
Practice Address - Street 1:6709 WYCLIFFE AVE
Practice Address - Street 2:
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173
Practice Address - Country:US
Practice Address - Phone:704-843-6565
Practice Address - Fax:704-843-6207
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7701101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional