Provider Demographics
NPI:1083931737
Name:TABBS, KARASHIA AURILLA (MBA, LCPC, NCC, LPC)
Entity Type:Individual
Prefix:MISS
First Name:KARASHIA
Middle Name:AURILLA
Last Name:TABBS
Suffix:
Gender:F
Credentials:MBA, LCPC, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 FOX MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:CAHOKIA
Mailing Address - State:IL
Mailing Address - Zip Code:62206-2503
Mailing Address - Country:US
Mailing Address - Phone:618-300-0366
Mailing Address - Fax:877-302-5640
Practice Address - Street 1:5 FOX MEADOW LN
Practice Address - Street 2:
Practice Address - City:CAHOKIA
Practice Address - State:IL
Practice Address - Zip Code:62206-2503
Practice Address - Country:US
Practice Address - Phone:618-300-0366
Practice Address - Fax:877-302-5640
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010033038101YP2500X
IL180007423101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional