Provider Demographics
NPI:1497996714
Name:URBANO, KAREN (LPC)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:URBANO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:ANN
Other - Last Name:URBANO GREGAITIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2096 B 2ND FLOOR
Mailing Address - Street 2:SILAS DEANE HIGHWAY
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067
Mailing Address - Country:US
Mailing Address - Phone:860-304-9633
Mailing Address - Fax:
Practice Address - Street 1:2096 B 2ND FLOOR
Practice Address - Street 2:SILAS DEANE HIGHWAY
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067
Practice Address - Country:US
Practice Address - Phone:860-304-9633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-17
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CT002109101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004235918Medicaid