Provider Demographics
NPI:1558411504
Name:KINDER, KAREN EYMAN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:EYMAN
Last Name:KINDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13318 E 1450TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:IL
Mailing Address - Zip Code:62448-3255
Mailing Address - Country:US
Mailing Address - Phone:618-562-2208
Mailing Address - Fax:618-783-2732
Practice Address - Street 1:13318 E 1450TH AVE
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:IL
Practice Address - Zip Code:62448-3255
Practice Address - Country:US
Practice Address - Phone:618-562-2208
Practice Address - Fax:618-783-2732
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-0011007101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional