Provider Demographics
NPI:1154483972
Name:WOODRING FREDERICKS, KARLA ELAINE (MA LPC)
Entity Type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:ELAINE
Last Name:WOODRING FREDERICKS
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:MRS
Other - First Name:KARLA
Other - Middle Name:E
Other - Last Name:WOODRING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA LPC
Mailing Address - Street 1:171 ENGLISH LANDING DRIVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:PARKVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64152
Mailing Address - Country:US
Mailing Address - Phone:816-746-5775
Mailing Address - Fax:816-746-5775
Practice Address - Street 1:171 ENGLISH LANDING DRIVE
Practice Address - Street 2:SUITE 220
Practice Address - City:PARKVILLE
Practice Address - State:MO
Practice Address - Zip Code:64152
Practice Address - Country:US
Practice Address - Phone:816-746-5775
Practice Address - Fax:816-746-5775
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001485101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional