Provider Demographics
NPI:1093188021
Name:BROWN WRIGHT, KAREN SUE (BS MHP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:SUE
Last Name:BROWN WRIGHT
Suffix:
Gender:F
Credentials:BS MHP
Other - Prefix:MRS
Other - First Name:KAREN
Other - Middle Name:SUE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS MHP
Mailing Address - Street 1:2274 STATE POND RD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:IL
Mailing Address - Zip Code:62952-2079
Mailing Address - Country:US
Mailing Address - Phone:618-697-4763
Mailing Address - Fax:
Practice Address - Street 1:408 E VINE ST
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:IL
Practice Address - Zip Code:62995-1612
Practice Address - Country:US
Practice Address - Phone:618-658-2611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health