Provider Demographics
NPI:1508072455
Name:GERNAEY, KAREN A (LCPC, CADC)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:A
Last Name:GERNAEY
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19W041 AVENUE BARBIZON
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1002
Mailing Address - Country:US
Mailing Address - Phone:630-515-1374
Mailing Address - Fax:
Practice Address - Street 1:410 HILLSIDE AVE
Practice Address - Street 2:#2
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-4513
Practice Address - Country:US
Practice Address - Phone:630-469-6989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-000411101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional