Provider Demographics
NPI:1568796522
Name:DEBIRK, KAREN MARIE (LPC)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:MARIE
Last Name:DEBIRK
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 1:1190 SPRING CREEK PL
Mailing Address - Street 2:SUITE D-2
Mailing Address - City:SPRINGVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84663-3045
Mailing Address - Country:US
Mailing Address - Phone:801-806-4226
Mailing Address - Fax:801-806-4227
Practice Address - Street 1:1190 SPRING CREEK PL
Practice Address - Street 2:SUITE D-2
Practice Address - City:SPRINGVILLE
Practice Address - State:UT
Practice Address - Zip Code:84663-3045
Practice Address - Country:US
Practice Address - Phone:801-806-4226
Practice Address - Fax:801-806-4227
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4913550-6004101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor