Provider Demographics
NPI:1669650974
Name:BLANDEN, KAREN R (LMHC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:R
Last Name:BLANDEN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5121 EHRLICH RD STE 104B
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-2015
Mailing Address - Country:US
Mailing Address - Phone:813-931-8113
Mailing Address - Fax:813-920-5191
Practice Address - Street 1:5121 EHRLICH RD STE 104B
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-2015
Practice Address - Country:US
Practice Address - Phone:813-931-8113
Practice Address - Fax:813-920-5191
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 8143101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health