Provider Demographics
NPI:1194040444
Name:NEWKIRK, KAREN KRISTINE (LCPC)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:KRISTINE
Last Name:NEWKIRK
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 YELLOWSTONE AVE
Mailing Address - Street 2:PMB 320
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-4406
Mailing Address - Country:US
Mailing Address - Phone:208-241-5533
Mailing Address - Fax:208-232-4944
Practice Address - Street 1:3350 W AMERICANA TER
Practice Address - Street 2:SUITE 300
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-2521
Practice Address - Country:US
Practice Address - Phone:208-343-1113
Practice Address - Fax:208-232-4944
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-30
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-4477101YA0400X, 101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional