Provider Demographics
NPI:1346803814
Name:KONOP, KAREN J (BCBA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:J
Last Name:KONOP
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:J
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1210 FOURIER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-1969
Mailing Address - Country:US
Mailing Address - Phone:608-662-9327
Mailing Address - Fax:608-662-9041
Practice Address - Street 1:1141 W MAIN AVE STE 201
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-1695
Practice Address - Country:US
Practice Address - Phone:920-338-1610
Practice Address - Fax:920-338-1616
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI288-140103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst