Provider Demographics
NPI:1477823227
Name:GRAYSON, KAREN (LPC)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:GRAYSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:858 DOERWOOD CT
Mailing Address - Street 2:
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-3010
Mailing Address - Country:US
Mailing Address - Phone:618-363-2621
Mailing Address - Fax:
Practice Address - Street 1:10406 MANCHESTER RD
Practice Address - Street 2:SUITE 211A
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-1524
Practice Address - Country:US
Practice Address - Phone:618-363-2621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009017144101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional