Provider Demographics
NPI:1386015378
Name:LOCK-BRYNE, KARYN LOUISE (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:KARYN
Middle Name:LOUISE
Last Name:LOCK-BRYNE
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 1:7600 GRAND RIVER RD
Mailing Address - Street 2:SUITE 290
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-7333
Mailing Address - Country:US
Mailing Address - Phone:810-220-2787
Mailing Address - Fax:
Practice Address - Street 1:7600 GRAND RIVER RD
Practice Address - Street 2:SUITE 290
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-7333
Practice Address - Country:US
Practice Address - Phone:810-220-2787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-15
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401005889101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health