Provider Demographics
NPI:1578851028
Name:SHOCKLEY, KAREN CATHLEEN (MS, LCPC)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:CATHLEEN
Last Name:SHOCKLEY
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SPINNING WHEEL RD
Mailing Address - Street 2:SUITE 426
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-2914
Mailing Address - Country:US
Mailing Address - Phone:630-323-3050
Mailing Address - Fax:
Practice Address - Street 1:15 SPINNING WHEEL RD
Practice Address - Street 2:SUITE 426
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-2914
Practice Address - Country:US
Practice Address - Phone:708-633-9003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007053101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional