Provider Demographics
NPI:1659034718
Name:MATUSKA, KAREN DIANE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:DIANE
Last Name:MATUSKA
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 TEMPLETON GAP RD STE 213
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-8714
Mailing Address - Country:US
Mailing Address - Phone:719-581-7589
Mailing Address - Fax:719-581-7589
Practice Address - Street 1:3225 TEMPLETON GAP RD STE 213
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-8714
Practice Address - Country:US
Practice Address - Phone:719-581-7589
Practice Address - Fax:719-715-0227
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-15
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0019798101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health