Provider Demographics
NPI:1508064221
Name:ROBERTIE, KAREN M (LCPC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:ROBERTIE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 N SCHUYLER AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901-3601
Mailing Address - Country:US
Mailing Address - Phone:815-348-4409
Mailing Address - Fax:
Practice Address - Street 1:110 N LOCUST ST
Practice Address - Street 2:
Practice Address - City:ONARGA
Practice Address - State:IL
Practice Address - Zip Code:60955-1213
Practice Address - Country:US
Practice Address - Phone:815-268-4001
Practice Address - Fax:815-268-7437
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005314101YP2500X
IL180.005314101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional