Provider Demographics
NPI:1336296102
Name:STAFFORD-MAY, KAREN (MA, LPC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:STAFFORD-MAY
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 WOODLAWN LN
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-9557
Mailing Address - Country:US
Mailing Address - Phone:517-263-2683
Mailing Address - Fax:866-223-1175
Practice Address - Street 1:403 N BROAD ST
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-2127
Practice Address - Country:US
Practice Address - Phone:517-266-8500
Practice Address - Fax:866-223-1175
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401002163101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor