Provider Demographics
NPI:1508204892
Name:LABRECQUE, KARYN ELIZABETH (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:KARYN
Middle Name:ELIZABETH
Last Name:LABRECQUE
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:IPSWICH
Mailing Address - State:MA
Mailing Address - Zip Code:01938-2240
Mailing Address - Country:US
Mailing Address - Phone:978-826-3527
Mailing Address - Fax:
Practice Address - Street 1:5 MIDDLESEX AVE UNIT 11
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:MA
Practice Address - Zip Code:01887-2745
Practice Address - Country:US
Practice Address - Phone:978-658-9889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-07
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4190101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health