Provider Demographics
NPI:1083134308
Name:JEANNETTE, KAREN MAKAR (LPC)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MAKAR
Last Name:JEANNETTE
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 1:79 HAYWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NC
Mailing Address - Zip Code:28390-9194
Mailing Address - Country:US
Mailing Address - Phone:571-205-8880
Mailing Address - Fax:
Practice Address - Street 1:8508 WESTOVER CT
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-1052
Practice Address - Country:US
Practice Address - Phone:571-205-8880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-27
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401223545101YM0800X
VA0701007019101YP2500X, 101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor