Provider Demographics
NPI:1639188907
Name:MCCONAUGHEY, KAREN S (LCPC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:S
Last Name:MCCONAUGHEY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6003 W OVERLAND RD STE 105
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-3075
Mailing Address - Country:US
Mailing Address - Phone:208-321-1212
Mailing Address - Fax:208-345-2077
Practice Address - Street 1:6003 W OVERLAND RD STE 105
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-3075
Practice Address - Country:US
Practice Address - Phone:208-321-1212
Practice Address - Fax:208-345-2077
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC 295101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor