Provider Demographics
NPI:1215205208
Name:BURGHOUT, KAREN ALLISON (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ALLISON
Last Name:BURGHOUT
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 1:644 S SCENIC AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65802-5072
Mailing Address - Country:US
Mailing Address - Phone:417-866-3293
Mailing Address - Fax:417-866-3294
Practice Address - Street 1:644 S SCENIC AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-5072
Practice Address - Country:US
Practice Address - Phone:417-866-3293
Practice Address - Fax:417-866-3294
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008003446101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional