Provider Demographics
NPI:1245414465
Name:LIEBOLD, KAREN (MA, LCPC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:LIEBOLD
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 S BARTLETT RD STE 106B
Mailing Address - Street 2:
Mailing Address - City:STREAMWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60107-2407
Mailing Address - Country:US
Mailing Address - Phone:224-318-7554
Mailing Address - Fax:
Practice Address - Street 1:820 S BARTLETT RD STE 106B
Practice Address - Street 2:
Practice Address - City:STREAMWOOD
Practice Address - State:IL
Practice Address - Zip Code:60107-2407
Practice Address - Country:US
Practice Address - Phone:224-318-7554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-24
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180004649101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional