Provider Demographics
NPI:1568005551
Name:HUCKABY, KAREN (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:HUCKABY
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 N VAN NESS BLVD
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-6014
Mailing Address - Country:US
Mailing Address - Phone:559-201-8680
Mailing Address - Fax:
Practice Address - Street 1:2001 N VAN NESS BLVD
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-6014
Practice Address - Country:US
Practice Address - Phone:559-201-8680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-22
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA116059106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist