Provider Demographics
NPI:1538702345
Name:ROUDKOVSKI, KAREN (LPC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:ROUDKOVSKI
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 1:445 BELLE POINTE DR
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70447-3162
Mailing Address - Country:US
Mailing Address - Phone:985-510-1175
Mailing Address - Fax:
Practice Address - Street 1:594 ASBURY DR STE E-10
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-4101
Practice Address - Country:US
Practice Address - Phone:985-510-1175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-24
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional