Provider Demographics
NPI:1407000649
Name:WELCH, KARI ANN (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:KARI
Middle Name:ANN
Last Name:WELCH
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MS
Other - First Name:KARI
Other - Middle Name:ANN
Other - Last Name:DANIELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:3132 OLD JACKSONVILLE RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-7400
Mailing Address - Country:US
Mailing Address - Phone:217-862-0737
Mailing Address - Fax:217-862-0844
Practice Address - Street 1:3132 OLD JACKSONVILLE RD
Practice Address - Street 2:SUITE 150
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-7400
Practice Address - Country:US
Practice Address - Phone:217-862-0737
Practice Address - Fax:217-862-0844
Is Sole Proprietor?:No
Enumeration Date:2008-11-14
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005605101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional