Provider Demographics
NPI:1326276288
Name:KARLICK, MAGDALENA (ATR-BC, LPCC)
Entity Type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:
Last Name:KARLICK
Suffix:
Gender:F
Credentials:ATR-BC, LPCC
Other - Prefix:
Other - First Name:MAGDALENA
Other - Middle Name:
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ATR-BC, LPCC
Mailing Address - Street 1:245 ROSARIO BLVD APT C
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501-1373
Mailing Address - Country:US
Mailing Address - Phone:917-626-5360
Mailing Address - Fax:
Practice Address - Street 1:245 ROSARIO BLVD APT C
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87501-1373
Practice Address - Country:US
Practice Address - Phone:917-626-5360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2022-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0144091101Y00000X
NM0146971101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor