Provider Demographics
NPI:1629711742
Name:KARR, LAURA MICHELLE (MA, LCPC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MICHELLE
Last Name:KARR
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 BALLYSHANNON DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-4113
Mailing Address - Country:US
Mailing Address - Phone:309-242-6280
Mailing Address - Fax:
Practice Address - Street 1:3485 N 1600 EAST RD
Practice Address - Street 2:
Practice Address - City:HEYWORTH
Practice Address - State:IL
Practice Address - Zip Code:61745-9103
Practice Address - Country:US
Practice Address - Phone:309-212-5847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-16
Last Update Date:2022-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health